989 ANAESTHESIOLOGICAL MANAGEMENT IN PATIENTS UNDERGOING TEER: A NEW APPROACH IMPROVES CV OUTCOMES

Abstract Background Transcatheter edge-to-edge repair (TEER) with the MitraClip system is an alternative procedure for treatment of severe mitral regurgitation (MR) in high-risk patients who are not suitable conventional surgery and usually performed under general anaesthesia (GA). GA may be associated potential haemodynamic complications. A new approach deep sedation (DS) spontaneous breathing using a target-controlled infusion (TCI). The aim this study to compare TCI during DS manual administration total intravenous (TIVA) undergoing TEER evaluating impact these approaches on time, remifentanil dose administered, profile, vasopressor requirements, adverse events postoperative hospital stay. Methods population included 90 consecutive treated (mean age 73.5 ± 9.54 years). 65 (72%) suffered from functional MR. Mean LVEF was 35 13% logistic EuroSCORE 23 19%. 24 received TIVA; 66 underwent TCI, consisting midazolam fentanyl citrate as induction followed by continuous hydrochloride. Results Acute procedural success 100%, no major complications procedure. No statistical differences were found between GA-TIVA DS-TCI group terms demographics surgical risk profile. Anaesthesia time significantly shorter (71 30 vs. 118 minutes; p < 0.0001), duration (54 29 99 74 = 0.00007). In addition, there significant reduction administered (249 µg 2865 µg, 0.01), incidence hypotension (p 0.08) need vasopressors (29.6% 63%, 0.03) group. There days stay after (5.4 5.8 days, 0.4). Conclusions could valid which can ensure stable anaesthetic conditions, less drug administration, higher stability fewer side effects, particular advantages at high anaesthesia.