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November 5, 2025LifeOpen Access

Advanced HPI monitoring during TAVI fails to reduce intraoperative hypotension compared to standard monitoring.

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Why the study?

Intraoperative hypotension worsens postoperative outcomes, making haemodynamic stability essential during TAVI in elderly and vulnerable patients, but the benefit of advanced versus standard haemodynamic monitoring was unclear.

Does advanced haemodynamic monitoring with Hypotension Prediction Index (HPI) reduce intraoperative hypotension in patients undergoing transfemoral TAVI?

Population

Fifty patients undergoing transfemoral TAVI under standard anaesthetic care

Comparison

Advanced haemodynamic monitoring with HPI values available vs covered HemoSphere monitor

Design

Prospective randomized pilot study

Key result

Advanced haemodynamic monitoring with HPI during TAVI showed no detectable difference in the time-weighted average of intraoperative hypotension (TWA65) compared to standard monitoring.

Authors

ABAstrid BergmannPWPhilip WoldtLSLena Steins

Discussion

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Member takes

Overview

HPI monitoring does not reduce TWA65 during TAVI; challenges assumptions of benefit from predictive haemodynamic tools.

Study Design

Type

RCT (n=50)

Blinding

Single-blind

Randomization

Randomized

Structured PICO

Does advanced haemodynamic monitoring with Hypotension Prediction Index (HPI) reduce intraoperative hypotension in patients undergoing transfemoral TAVI?

P
Population
50 patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) under standard anaesthetic care
I
Intervention
Advanced haemodynamic monitoring using Edwards Acumen sensors with Hypotension Prediction Index (HPI) values available to the anaesthetist
C
Comparator
Standard haemodynamic monitoring (HemoSphere monitor covered, HPI values unavailable to the anaesthetist)
O
Outcome
Time-weighted average of intraoperative hypotension adjusted for the duration of surgery (TWA65)surrogate

The use of the Hypotension Prediction Index during TAVI reduces the overall duration of intraoperative hypotension, potentially improving haemodynamic stability in vulnerable patients.

Cite This Study

Bergmann et al. (2025) conducted an RCT in Transfemoral Aortic Valve Replacement (TAVI) (n=50). Advanced haemodynamic monitoring with Hypotension Prediction Index (HPI) vs. Standard monitoring (HemoSphere monitor covered) was evaluated on Time-weighted average of intraoperative hypotension (TWA65). Advanced haemodynamic monitoring with HPI during TAVI showed no detectable difference in the time-weighted average of intraoperative hypotension (TWA65) compared to standard monitoring.

synapsesocial.com/papers/6a0f7c49fa36b6e053fcb795https://doi.org/10.3390/life15111714
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Machine Learning-Guided Hypotension Prediction and Goal-Directed Therapy During Transcatheter Valve Repair: A Prospective Observational Study2026
  2. 2Predictors and Prognostic Impact of Perioperative Hypotension During Transcatheter Aortic Valve Implantation: The Role of Diabetes Mellitus and Left Ventricular Dysfunction2025
  3. 3Predictive vs. Flow-Derived Haemodynamic Monitoring in Major Abdominal Surgery: Associations with Intraoperative Hypotension and Postoperative Outcomes2026
  4. 4Non-Invasive Hemodynamic Monitoring in Transcatheter Aortic Valve Implantation2025
  5. 5Postinduction Hypotension and Adverse Outcomes in Older Adults Undergoing Transcatheter Aortic Valve Replacement: A Retrospective Cohort Study2024 · 5 citations