Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study
Abstract Background The aim of this study was to investigate whether the level of decrease in cerebral oxygen saturation during the valve placement phase of the transcatheter aortic valve implantation (TAVI) procedure under sedation has an effect on postoperative delirium (POD). Methods The study in...
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BMC
2025-02-01
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| Online Access: | https://doi.org/10.1186/s12871-025-02950-1 |
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| author | Hulya Yilmaz Ak Baris Sandal Yasemin Ozsahin Ziya Salihoglu Ahmet Yildiz Esra Erturk Tekin Mehmet Ali Yesiltas Mustafa Yildiz Kerem Erkalp |
| author_facet | Hulya Yilmaz Ak Baris Sandal Yasemin Ozsahin Ziya Salihoglu Ahmet Yildiz Esra Erturk Tekin Mehmet Ali Yesiltas Mustafa Yildiz Kerem Erkalp |
| author_sort | Hulya Yilmaz Ak |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to investigate whether the level of decrease in cerebral oxygen saturation during the valve placement phase of the transcatheter aortic valve implantation (TAVI) procedure under sedation has an effect on postoperative delirium (POD). Methods The study initially assessed 50 patients between the ages of 50 and 90 years with an indication for TAVI by the cardiac team. Regional cerebral oxygen saturation (rScO2) was measured using Near-infrared spectroscopy (NIRS) before the procedure (T1), during surgical field sterilization (T2), catheter placement (T3), wire manipulation (T4), valve placement (T5) and access site artery repair (T6). Confusion Assessment Method for The Intensive Care Unit (ICU-CAM) test was performed on intensive care unit and the presence of POD was questioned. Patients were divided into two groups as those without POD (Group 1) and those with POD (Group 2). Results The study was completed with 41 patients in total. While POD was present in 12 (29.3%) of the patients evaluated intensive care unit, POD was not observed in 29 (70.7%) patients. The rScO2 value measured at T5 was significantly lower in Group 2 compared to Group 1 (p < 0.001). Conclusions In our study, the rate of POD after TAVI was as high as 29.3%. Low rScO2 during valve placement was associated with delirium. Our findings indicate that NIRS devices could be a useful tool for assessing the risk of POD during the TAVI procedure; however, further research is needed to validate their routine clinical use. |
| format | Article |
| id | doaj-art-8a2037d0f89f4ac6b4a8116a684cb5e2 |
| institution | DOAJ |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-8a2037d0f89f4ac6b4a8116a684cb5e22025-08-20T03:10:56ZengBMCBMC Anesthesiology1471-22532025-02-0125111010.1186/s12871-025-02950-1Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational studyHulya Yilmaz Ak0Baris Sandal1Yasemin Ozsahin2Ziya Salihoglu3Ahmet Yildiz4Esra Erturk Tekin5Mehmet Ali Yesiltas6Mustafa Yildiz7Kerem Erkalp8Department of Anesthesiology and Reanimation, Kartal Dr. Lutfi Kirdar City HospitalDepartment of Biostatistics, Cerrahpaşa Faculty of Medicine, Istanbul University-CerrahpaşaDepartment of Anesthesiology and Reanimation, Cardiology Institute, Istanbul University-CerrahpaşaDepartment of Anesthesiology and Reanimation, Cardiology Institute, Istanbul University-CerrahpaşaDepartment of Cardiology, Memorial Bahçelievler HospitalDepartment of Cardiovascular Surgery, Mersin City Training and Research HospitalDepartment of Cardiovascular Surgery, Prof. Dr. Cemil Tascioglu City HospitalDepartment of Cardiology, Cardiology Institute, Istanbul University-CerrahpaşaDepartment of Anesthesiology and Reanimation, Cardiology Institute, Istanbul University-CerrahpaşaAbstract Background The aim of this study was to investigate whether the level of decrease in cerebral oxygen saturation during the valve placement phase of the transcatheter aortic valve implantation (TAVI) procedure under sedation has an effect on postoperative delirium (POD). Methods The study initially assessed 50 patients between the ages of 50 and 90 years with an indication for TAVI by the cardiac team. Regional cerebral oxygen saturation (rScO2) was measured using Near-infrared spectroscopy (NIRS) before the procedure (T1), during surgical field sterilization (T2), catheter placement (T3), wire manipulation (T4), valve placement (T5) and access site artery repair (T6). Confusion Assessment Method for The Intensive Care Unit (ICU-CAM) test was performed on intensive care unit and the presence of POD was questioned. Patients were divided into two groups as those without POD (Group 1) and those with POD (Group 2). Results The study was completed with 41 patients in total. While POD was present in 12 (29.3%) of the patients evaluated intensive care unit, POD was not observed in 29 (70.7%) patients. The rScO2 value measured at T5 was significantly lower in Group 2 compared to Group 1 (p < 0.001). Conclusions In our study, the rate of POD after TAVI was as high as 29.3%. Low rScO2 during valve placement was associated with delirium. Our findings indicate that NIRS devices could be a useful tool for assessing the risk of POD during the TAVI procedure; however, further research is needed to validate their routine clinical use.https://doi.org/10.1186/s12871-025-02950-1Postoperative deliriumTranscatheter aortic valve implantationNear-Infrared spectroscopy |
| spellingShingle | Hulya Yilmaz Ak Baris Sandal Yasemin Ozsahin Ziya Salihoglu Ahmet Yildiz Esra Erturk Tekin Mehmet Ali Yesiltas Mustafa Yildiz Kerem Erkalp Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study BMC Anesthesiology Postoperative delirium Transcatheter aortic valve implantation Near-Infrared spectroscopy |
| title | Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study |
| title_full | Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study |
| title_fullStr | Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study |
| title_full_unstemmed | Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study |
| title_short | Association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium: a prospective observational study |
| title_sort | association between periprocedural cerebral desaturation during transcatheter aortic valve implantation and postprocedural delirium a prospective observational study |
| topic | Postoperative delirium Transcatheter aortic valve implantation Near-Infrared spectroscopy |
| url | https://doi.org/10.1186/s12871-025-02950-1 |
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