Anesthesia Considerations for Transcatheter Mitral and Aortic Valve Procedures

Purpose of Review: This review considers the anesthetic management for patients undergoing transcatheter mitral valve replacement and repair (TMVR and TMVRep) and transcatheter aortic valve replacement (TAVR). Clinical indications and preoperative considerations will be discussed before exploring intraoperative anesthetic management and potential complications. To conclude, the echocardiographic assessment for each procedure will be reviewed. Recent Findings: Advancements in transcatheter techniques have made it a viable option for patients who are poor surgical candidates. As a result, anesthetic management, including preoperative and intraoperative consideration, have other variables that are taken into account during workup. Intraoperative management may also differ such as the use of monitored anesthesia care (MAC) versus general anesthesia and the use of intraoperative transesophageal echocardiography (TEE). Summary: Transcatheter mitral and aortic valve procedures now play a large role in the management of patients with valvular heart disease and as a result have become increasingly more prevalent as a treatment option versus surgical intervention. Therefore, anesthesiologists should be knowledgeable about indications for the transcatheter technique, variable anesthetic techniques, and how to watch for and manage complications that can arise.