Anesthetic Considerations for the Transcatheter Management of Mitral Valve Disease

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 33; no. 3; pp. 796 - 807
• Main Authors: Gregory, Stephen H., Sodhi, Nishtha, Zoller, Jonathan K., Quader, Nishath, Ridley, Clare H., Maniar, Hersh S., Lasala, John M., Zajarias, Alan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2019
• Subjects: anesthesia; cardiac surgical procedures; mitral regurgitation; mitral stenosis; mitral valve; transcatheter valve replacement care; transcatheter valve replacement care; mitral valve; mitral regurgitation; cardiac surgical procedures; mitral stenosis; anesthesia
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2018.05.054

The development of transcatheter interventions to provide a minimally invasive alternative to open surgical repair has revolutionized the care of patients with valvular heart disease. Recently, this technology has been expanded to allow for the treatment of pathology of the mitral valve. This review discusses the anesthetic considerations for patients presenting for transcatheter management of mitral valve disease, including transcatheter mitral valve replacement (TMVR) and transcatheter mitral valve repair (TMVRep). The initial focus is on the current literature on transcatheter interventions for mitral valve pathologies as well as current and developing technology for TMVR and TMVRep. The authors’ institutional experience with anesthetic management for the TMVR and TMVRep procedures is described, including potential pitfalls and complications, concluding with a discussion of the role of transesophageal echocardiography in the care of this patient population.