AIM To explore the application of extracorporeal circulation in transcatheter aortic valve replacement (TAVR).
METHODS We retrospectively analyzed 25 consecutive cases of TAVR assisted by extracorporeal circulation completed from May 2018 to December 2019 in the Department of Cardiovascular Surgery of Xijing Hospital, and compared the efficacy of extracorporeal membrane oxygenation (ECMO, n=8) and cardiopulmonary bypass (CPB, n=15), the left two patients received CPB and ECMO one after another. Besides, we compared the basic conditions of patients in emergency (n=13) and non-emergency (n=12) groups based on clinical experience.
RESULTS Compared with the ECMO group, the ratio of male and body weight were lower and the ejection fraction was higher in the CPB group (all P<0.05). Compared with the non-emergency group, the ratio of male and body weight were lower and the ejection fraction was higher in the emergency group (all P<0.05). Compared with the ECMO group, the operation time was significantly increased in the CPB group (P<0.01). Compared with the non-emergency group, the operation time was significantly increased in the emergency group (P<0.01). Compared with the ECMO group, postoperative arterial blood PaO2 (P<0.01) was increased, postoperative urine volume (P<0.01) and CCU time (P<0.01) were significantly decreased in the CPB group. Compared with the non-emergency group, postoperative arterial blood PaO2 (P<0.01), postoperative urine volume (P<0.01) and CCU time (P<0.01) were significantly increased in the non-emergency group.
CONCLUSION Extracorporeal circulation is necessary in the process of TAVR. CPB should be the first choice for circulatory assistance, followed by ECMO. But, the circulatory assistance method should be flexibly selected based on the specific conditions of the patient and various emergencies during the operation so as to achieve the best results.
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