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August 1, 2026Journal of Cardiothoracic and Vascular AnesthesiaOpen Access

HPI guidance during transcatheter valve repair links to a median time-weighted hypotension of 0.17 mmHg.

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Why the study?

Percutaneous transcatheter valve repair can cause hemodynamic instability and an elevated burden of intraoperative hypotension, prompting the need to evaluate machine learning-guided hemodynamic management.

Does HPI-based hemodynamic guidance reduce intraoperative hypotension in patients undergoing percutaneous transcatheter valve repair?

Population

69 patients undergoing PTVR

Comparison

Proactive treatment protocol when Hypotension Prediction Index exceeded 85

Design

Prospective observational study

Follow-up

Average monitoring time of 191.61 ± 52 minutes per patient

Key result

Hemodynamic guidance using the Hypotension Prediction Index during transcatheter valve repair resulted in a median time-weighted average mean arterial pressure <65 mmHg of 0.17 mmHg.

Authors

FLFrancesca LombardiLFLuciano FrassanitoPRPasquale Raimondo

Discussion

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Member takes

Overview

HPI guidance may attenuate IOH burden during PTVR; leaves open outcome benefit in randomized trials.

Study Design

Type

Observational (n=69)

Structured PICO

Does HPI-based hemodynamic guidance reduce intraoperative hypotension in patients undergoing percutaneous transcatheter valve repair?

P
Population
69 patients undergoing percutaneous transcatheter valve repair managed with HPI-based hemodynamic guidance.
E
Exposure
Hemodynamic guidance based on the Hypotension Prediction Index (HPI) algorithm, with a proactive treatment protocol to prevent hypotension provided when HPI exceeded 85.
O
Outcome
Time weighted average (TWA) - mean arterial pressure (MAP) under 65 mmHg thresholdsurrogate

Application of an HPI-based hemodynamic guidance algorithm during percutaneous transcatheter valve repair limits the incidence and severity of intraoperative hypotension.

Cite This Study

Lombardi et al. (2026) conducted an observational in Percutaneous transcatheter valve repair (n=69). Hypotension Prediction Index (HPI) based hemodynamic guidance was evaluated on Time weighted average (TWA) mean arterial pressure (MAP) under 65 mmHg threshold. Hemodynamic guidance using the Hypotension Prediction Index during transcatheter valve repair resulted in a median time-weighted average mean arterial pressure <65 mmHg of 0.17 mmHg.

synapsesocial.com/papers/6a87dd5591c33485a1fe82d9https://doi.org/10.1053/j.jvca.2026.07.054
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Also Consider

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

  1. 1The use of a machine-learning algorithm that predicts hypotension during surgery in combination with personalized treatment guidance: study protocol for a randomized clinical trial2019 · 25 citations
  2. 2Advanced Haemodynamic Monitoring During Transfemoral Aortic Valve Replacement: A Prospective Pilot Study2025
  3. 3Hypotension Prediction Index Software Compared with Standard Advanced Haemodynamic Monitoring in Patients Undergoing Major Aortic Surgery: A Retrospective Study2025
  4. 4Hypotension prediction index in surgical patients: A systematic review and meta-analysis of randomized controlled trials2026 · 1 citations
  5. 5Intraoperative hypotension prediction in cardiac and noncardiac procedures: is HPI truly worthwhile? A systematic review and meta-analysis2025