ObjectiveTo explore the risk factors and potential mechanisms of hypertension events on the same day after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis. MethodsClinical data of patients who underwent TAVI for severe aortic stenosis at Department of Structural Heart Disease, Fuwai Hospital from December 2023 to February 2024 were retrospectively collected. According to the peak systolic blood pressure on the same day after surgery, patients were divided into a hypertension group (≥140 mm Hg) and a normal blood pressure group (<140 mm Hg). Logistic regression model was used to analyze the risk factors for hypertension on the same day after TAVI. ResultsA total of 54 patients after TAVI were included, with 41 patients in the hypertension group, including 18 males and 23 females, with an average age of 72.83±6.78 years; 13 patients in the normal blood pressure group, including 9 males and 4 females, with an average age of 70.00±7.57 years. Univariate analysis found that there were statistical differences in interventricular septal thickness (13.71±1.98 mm vs. 12.23±1.59 mm, P=0.018), preoperative left ventricular ejection fraction (LVEF)>55% [33 (80.5%) vs. 6 (46.2%), P=0.040], and postoperative same-day LVEF>55% [33 (80.5%) vs. 4 (30.8%), P=0.003]. Multivariate logistic regression analysis found that postoperative same-day LVEF>55% [OR=10.173, 95%CI (1.044, 99.115), P=0.046] was an independent risk factor for hypertension on the same day after TAVI. ConclusionMyocardial contractility mainly participates in the occurrence of hypertension on the same day after TAVI. This study can not only improve our understanding of early hemodynamic changes after TAVI but also provide a basis for the formulation of early hypertension treatment plans after TAVI to improve the short- and long-term prognosis of patients.
Enhanced recovery after surgery (ERAS) has been proven to reduce surgical injuries, promote recovery, and improve postoperative outcomes in different types of surgeries. A core principle of ERAS is to provide programmatic evidence-based perioperative interventions. An international multidisciplinary expert group provided a statement on clinical practice in each thematic area of ERAS by obtaining a list of potential ERAS elements, and reviewing literature. The "Version 2024 of the ERAS Joint Consensus Statement" is developed from the "Version 2019 of the ERAS Recommendations". The consensus statement group was composed of multidisciplinary experts such as cardiac surgeons, anesthesiologists, intensive care physicians, and nurses, based on ERAS's personal professional knowledge and experience. This article interprets the changes and new statements in the 2024 consensus, which can provide a foundation for the best perioperative practices for adult cardiac surgery patients.