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Cerebral regional oxygen saturation as a predictive parameter for preoperative heart failure and delayed hemodynamic recovery in transcutaneous aortic valve implantation: a retrospective cohort study

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Abstract

This study aimed to investigate the relationship of perioperative cerebral regional oxygen saturation (rSO2) with various preoperative clinical variables and hemodynamic changes during transfemoral transcatheter aortic valve implantation (TAVI) under general anesthesia. We retrospectively analyzed cerebral rSO2 values from left-hemisphere measurements obtained using near-infrared spectroscopy (O3™ regional oximetry) at five time points: pre-induction, the start of the procedure, the start of valve deployment, time of lowest cerebral rSO2 value during valve deployment, and the end of the procedure. This study included 91 patients (60 with balloon-expandable valves and 31 with self-expandable valves). The baseline cerebral rSO2 values were correlated with B-type natriuretic peptide, hemoglobin, fractional shortening, ejection fraction, left ventricular mass index, left ventricular end-systolic diameter, STS risk of mortality, and STS morbidity or mortality. The patients who took longer to recover their systolic blood pressure to 90 mmHg after valve deployment with a balloon-expandable valve (group B) had lower cerebral rSO2 values during deployment compared to patients with faster recovery with balloon-expandable valve (group A) and with self-expandable valve (group C). Baseline cerebral rSO2 is associated with preoperative variables related to cardiac failure and function, and a significant decline during valve deployment may indicate a risk of prolonged hypotension during TAVI.

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Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Juntedo University Hospital, 3-1-3, Hongo, Bunkyo-ku, Tokyo, Japan

    Shihoko Iwata

  2. Nishiarai Nursing School, Tokyo, Japan

    Makoto Ozaki

Authors
  1. Shihoko Iwata
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  2. Makoto Ozaki
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Contributions

SI conducted the study, collected and analyzed the data, and prepared the manuscript. MO supported data analysis and manuscript preparation.

Corresponding author

Correspondence to Shihoko Iwata.

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Ethical approval

Cerebral rSO2 values were obtained from anesthetized patients with ethical approval (No. 5511) from the Institutional Review Board of Tokyo Women’s Medical University Hospital.

Consent to participate and for publication

For this non-interventional and noninvasive retrospective observational study, the requirement for informed patient consent was waived by the IRB of TWMU. Patients were provided with an opt-out option, of which they were notified on the homepage of the TWMU.

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The authors declare no competing interests.

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Iwata, S., Ozaki, M. Cerebral regional oxygen saturation as a predictive parameter for preoperative heart failure and delayed hemodynamic recovery in transcutaneous aortic valve implantation: a retrospective cohort study. J Clin Monit Comput (2024). https://doi.org/10.1007/s10877-024-01129-2

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  • DOI: https://doi.org/10.1007/s10877-024-01129-2

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