Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established alternative for patients with severe aortic stenosis who are unsuitable for surgical valve replace-ment. Conscious sedation is preferred to preserve spontaneous respiration and patient cooperation. Dexmedetomidine, a selective α2-adrenergic agonist, provides sedation, analgesia, and sympatholysis with minimal respiratory depression, making it suitable for high-risk TAVI patients. METHODS: We retrospectively analyzed 53 patients who underwent TAVI under dexme-detomidine-based sedation at a single center between January and July 2025. Patients received an initial loading dose of dexmedetomidine (1 μg/kg over 15 minutes) and fen-tanyl (1 μg/kg), followed by dexmedetomidine infusion (0.2-1.2 μg/kg/h) to achieve a Ramsay Sedation Score of 3-4 and bispectral index (BIS) 70-80. Hemodynamic param-eters were recorded at baseline (T0), post-loading (T1), 10 minutes post-loading (T2), and end of procedure (T3). Hemodynamic compromise was defined as a >30% decrease in systolic or mean arterial pressure(MAP) <65 mm Hg. RESULTS: The mean age was 76.4 ± 7.3 years, with 58.5% female; all patients were ASA III-IV. Mean arterial pressure (MAP) remained above 65 mm Hg at all time points, with the greatest decrease at T2. Systolic and MAP reductions were consistently below the 30%threshold. Postoperative complications included pacemaker implantation in 2 patients, transient contrast-induced nephropathy in 1, and temporary inotropic support in 4. No anesthesia-related respiratory complications occurred. CONCLUSIONS: Dexmedetomidine combined with fentanyl provides safe and effective sedation for TAVI, maintaining hemodynamic stability and spontaneous respiration. This sedation protocol minimizes perioperative risks and may improve procedural safety in high-risk patients.
Institution: İzmir Şehir Hastanesi
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7131124978
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