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J Thorac Cardiovasc Surg 2003;125:1526-1527
© 2003 The American Association for Thoracic Surgery

Brief Communications

Aortic valve replacement in the conscious patient under regional anesthesia without endotracheal intubation

Thomas Schachner, MDa, Johannes Bonatti, MDa, Doris Balogh, MDb, Josef Margreiter, MDb, Peter Mair, MDb, Günther Laufer, MDa, Günther Putz, MDb Innsbruck, Austria

From the Departments of Cardiac Surgerya and Anesthesia and Critical Care Medicine,b University Hospital, Innsbruck, Austria.

Received for publication June 28, 2002. Accepted for publication July 10, 2002. Address for reprints: Günther Putz, MD, Associate Professor of Anesthesiology and Critical Care Medicine, Dept of Anesthesia and Critical Care Medicine, Innsbruck University Hospital, Anichstrasse 35, 6020 Innsbruck, Austria (E-mail: Guenther.Putz@uibk.ac.at).

The first 20% of the full text of this article appears below.

See related articles on pages 1204, 1394, and 1401.

Minimally invasive operative procedures are of increasing interest to surgeons, including cardiac surgeons. Aside from the obvious advantage of reducing the surgical trauma, implementation of regional anesthesia is currently under investigation in heart surgery. Our aim was to determine the feasibility of using regional anesthesia without endotracheal intubation in aortic valve replacement with extracorporeal circulation in the conscious patient.

Patient and methods

The patient was a 70-year-old (171 cm, 73 kg) man with aortic valve stenosis (mean gradient 55 mm Hg) and hypertension. Preoperative coronary angiography showed no significant coronary artery stenosis. Informed consent was obtained before intervention. Epidural anesthesia was initiated immediately before the operation. The epidural space was located at the C7-T1 level with an 18G Tuohy needle (B. Braun Melsungen AG, Melsungen, Germany) by the hanging drop technique. A 20G catheter (B. Braun Melsungen) was inserted, and analgesia . . . [Full Text of this Article]


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