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percutaneous cardiac surgery ; aortic stenosis ; aortic valve replacement ; extracorporeal membrane oxygenation ; postcardiotomy cardiogenic shock
Abstract:
1) The main objective of the study was to analyse the factors influencing the outcomes of the VA ECMO therapy in patients affected by cardiogenic shock. Primarily, the survival rate for the group of patients supported with VA ECMO was to be determined. 2) The authors present their own experience of the treatment of patients qualified for transcatheter aortic valve implantation (TAVI). The objective of the present study was to demonstrate the initial results of conducting anaesthesia in high-risk patients qualified for the TAVI procedure. Ad 1) The hospital mortality rate reached 59% (17/29). Such factors as age, sex, height, type of hospital admission, accompanying diseases or the size of the ejection fraction of the left ventricle at the admission to the hospital, haven't shown any specific influence on the mortality. The group of patients who recovered after the therapy, spent significantly more time in the Intensive Care Unit (P=0,03) as well as in the hospital (P=0,02). Ad 2) All patients, after 12±5 days of treatment, left the hospital in a good neurological condition, which was assessed based on the CPC-1 (Cerebra Performance Categories Scale) and GCS-15 (Glasgow Coma Scale) scales. With an ejection fraction of the left ventricle of 53±11%, the transcatheter aortic valve was successfully implanted Ad 1) VA ECMO is an acceptable form of therapy for the treatment of patie ; nts in severe cardiogenic shock. The 41% of the patients recovered from cardiogenic shock due to the VA ECMO ’s application Ad 2) Percutaneous aortic valve implantation can be successfully conducted under remifentanil analgosedation TAVI procedures should be performed in the conditions of a modern, well-equipped hybrid room.