Cardiopulmonary bypass in transcatheter aortic valve implantation

Jiang Chunjing; Yang Feng; Hao Xing; Guo Dong; Xu Bo; Hei Feilong; Hou Xiaotong

doi:10.13498/j.cnki.chin.j.ecc.2024.02.06

Abstract：Objective This study systematically reviewed the experience of cardiopulmonary bypass(CPB)during transcatheter aortic valve implantation(TAVI)or transapical aortic valve replacement(TAVR)in our center in recent years,in order to provide experience for the treatment of patients.Methods The data of patients undergoing TAVI and TAVR surgery in our center from January 2019 to December 2021 were collected.CPB patients were divided into death group and survival group according to the outcome.Logistic analysis was used to analyze the factors affecting the outcome of CPB patients.Result A total of 348 patients with TAVI and TAVR were collected,of whom 60.9%were male,with an average age of 72±9 years.The in-hospital mortality was 13.5%.19 cases(5.5%)received CPB assistance during operation,and their in-hospital mortality was significantly higher than that of non CPB patients(42.1%vs 11.9%,P<0.05),The main reason of CPB was the complication of cardiac arrest in operation center;The CPB establishment time in the death group was significantly longer than that in the survival group(28±6min vs 21±3 min,P<0.01).The results of binary logistic regression analysis indicated that the apical approach was a high-risk factor for receiving CPB assistance during surgery,and the length of establishment time affected the outcome of CPB patients.Conclusion The TAVR transapical surgical approach is a high-risk factor for receiving CPB assistance during surgery,and CPB patients have a higher in-hospital mortality rate.A comprehensive CPB strategy can shorten the time for establishing CPB and thereby reduce in-hospital mortality.