Temporary decrease in microvascular tissue saturation after transcatheter aortic valve implantation

Article type: Research Article

Authors: Stern, Manuel^{a; 1; *} | Baasen, Sven^{a; 1} | Wischmann, Patricia^a | Herbrand, Theresa^a | Schremmer, Johanna^a | Maier, Oliver^a | Stern, Marc^a | Jung, Christian^a | Heiss, Christian^{b; c} | Kelm, Malte^{a; d} | Sansone, Roberto^a | Busch, Lucas^a

Affiliations: [a] Department of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Duesseldorf, Germany | [b] Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK | [c] Department of Vascular Medicine, Surrey and Sussex NHS Healthcare Trust, Redhill, UK | [d] Cardiovascular Research Institute Duesseldorf (CARID), Duesseldorf, Germany

Correspondence: [*] Corresponding author: Manuel Stern, Department of Cardiology, Pulmonology, and Vascular Medicine, University hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany. Tel.: +49 211 81 04424; Fax: +49 211 81 18812; E-mail: manuel.stern@med.uni-duesseldorf.de.

Note: [1] Contributed equally to this paper.

Abstract: BACKGROUND:Data on the effect of transcatheter aortic valve implantation (TAVI) on peripheral microcirculation are limited. OBJECTIVE:The aim of this study is to evaluate peripheral microvascular tissue saturation (StO2) before and after TAVI in relation to central and peripheral hemodynamics, cardiac and renal function. METHODS:In this single-center prospective study, patients with severe aortic stenosis (sAS) scheduled for TAVI or cardiac catheterization (control) were assessed before and up to five days after the procedure. Cardiac function including cardiac output (CO) was assessed by echocardiography. Brachial (bBP) and central blood pressure (cBP), ankle brachial index (ABI), and parameters of arterial stiffness, including augmentation pressure (AP) and augmentation index adjusted for heart rate (AIx@HR75) were measured to assess hemodynamic changes. StO2 was measured in all extremities using a near-infrared spectroscopy (NIRS) camera. Renal function was measured by creatinine levels. RESULTS:26 patients underwent TAVI and 11 patients served as control. Cardiac output was significantly increased, whereas hemodynamic parameters and peripheral StO2 were significantly decreased after TAVI. At follow-up, StO2 returned to baseline values. Changes in StO2 were negatively related to creatinine levels. CONCLUSION:Transcatheter aortic valve implantation causes a temporary decrease in microvascular tissue saturation that is associated with renal function.

Keywords: Microcirculation, microvascular tissue saturation, transcatheter aortic valve implantation, near-infrared spectroscopy

DOI: 10.3233/CH-232051

Journal: Clinical Hemorheology and Microcirculation, vol. 88, no. 2, pp. 221-234, 2024