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Use of Pleth Variability Index as a Non-invasive, Dynamic Indicator of Left Atrial Pressure Change During MitraClip: Transcatheter Mitral Valve Repair.
Vaidyanathan, Ashwin; Guruswamy, Jayakar; Saluja, Abhishek; Eng, Marvin; Szymanski, Trevor.
Afiliación
  • Vaidyanathan A; Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Hospital, Detroit, MI, USA.
  • Guruswamy J; Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Hospital, Detroit, MI, USA.
  • Saluja A; Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Hospital, Detroit, MI, USA.
  • Eng M; Structural Heart Program, Banner University Medical Center, Phoenix, AZ, USA.
  • Szymanski T; Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Hospital, Detroit, MI, USA.
Semin Cardiothorac Vasc Anesth ; 28(3): 147-151, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38864441
ABSTRACT

BACKGROUND:

Transcatheter edge-to-edge repair (TEER) with MitraClip is a safe and effective alternative to surgical mitral valve repair/replacement in patients with high operative risk. Pleth Variability Index (PVI) is a non-invasive, dynamic index based on analysis of the respiratory variations in the plethysmographic waveform recorded transcutaneously by the pulse oximeter.

OBJECTIVES:

The objective of the study was to evaluate if the hemodynamic effect of improved left-sided output after successful transcatheter mitral valve repair would lead to a significant change in PVI, and if it would correlate with the decrease in left atrial pressure (LAP).

DESIGN:

Prospective, observational cohort study (ClinicalTrials.gov NCT03993938).

SETTING:

Single academic hospital in Detroit, Michigan (USA), from October 2019 to February 2021.

PARTICIPANTS:

The authors included adult patients with severe mitral regurgitation who underwent successful MitraClip placement. MEASUREMENTS AND MAIN

RESULTS:

Of 30 patients, all components of the LAP (a wave, v wave, and mean) decreased significantly after successful MitraClip placement (P < .01). The median (IQR) PVI increased from 21 (11-35) to 23 (13-38) after clip placement; however, this change was not statistically significant (P = .275). No significant correlation between change in PVI and change in LAP was observed (P = .235).

CONCLUSIONS:

In patients with severe mitral regurgitation, successful MitraClip resulted in a significant reduction in LAP without a significant change in PVI. A larger sample size may provide more insight on the utility of using PVI as an indicator of LAP change in patients with mitral regurgitation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Cardíaco / Presión Atrial / Insuficiencia de la Válvula Mitral Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Semin Cardiothorac Vasc Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Cardíaco / Presión Atrial / Insuficiencia de la Válvula Mitral Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Semin Cardiothorac Vasc Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos