Relationships Between Intraoperative Hemodynamic Parameters and Delayed Hemodynamic Recovery After Valve Deployment in Transcatheter Aortic Valve Replacement

Objective: To determine the relationships between intraoperative hemodynamic parameters and delayed hemodynamic recovery after valve deployment and identify the predictive factors of delayed hemodynamic recovery by focusing on intraoperative hemodynamics in patients with transcatheter aortic valve replacement (TAVR). Design: A retrospective study. Setting: A single university hospital. Participants: Sixty-four patients who underwent elective TAVR between 2015 and 2017. Interventions: No intervention. Measurements and Main Results: The 64 patients were divided into the following 2 groups according to the time for recovery: systolic arterial pressure exceeded 90 mmHg and central venous oxygen saturation (ScvO ₂ ) exceeded 65%—delayed recovery (DR) (n = 36) group, and early recovery (ER) (n = 28) group. ScvO ₂ in the DR group was not lower than that in the ER group after induction of anesthesia. However, ScvO ₂ in the DR group gradually decreased and was lower than that in the ER group before valve deployment, despite improvement in blood pressure through the administration of vasopressor agents. Conclusion: ScvO ₂ monitoring during TAVR is useful to predict delayed recovery greater than 60 seconds after valve deployment in TAVR.