TAVI

Airway: Sedation or GA. Access: Wide-bore IV, arterial line, consider central line or pacing wire. Pain: Position: Time: Blood loss: Special:

Transarterial/endoluminal insertion of a prosthetic aortic valve. Anaesthetic strategies include:

Considerations

  • C
    • Severity
      Stenosis will worsen as sheath is positioned across the aortic valve. If AVA is already very low, then acute LV failure may occur.
    • Pacing wire
      Potential for LBBB to occur during valve placement secondary to AV nodal damage. Consider pacing wire insertion in patients who are:
      • Extremely unwell
      • Have a prexisting RBBB

Preparation

Induction

Intraoperative

Surgical Stages

  • Cannulation of femoral vessel
  • Placement of sheath through the aortic valve
  • Balloon dilation of aortic valve
  • Removal of large femoral sheath

Postoperative


References