Key result
SAVR is linked to significant microcirculatory disruption, while TAVR preserves tissue oxygenation and perfusion.
Why the study?
Hyperspectral Imaging was evaluated to assess the effects of cardiac surgery and cardiopulmonary bypass on microcirculation in patients with severe aortic stenosis.
Does Hyperspectral Imaging (HSI) detect microcirculatory changes in patients with severe aortic stenosis undergoing TAVR compared to SAVR?
Observational (n=40)
No
Does Hyperspectral Imaging (HSI) detect microcirculatory changes in patients with severe aortic stenosis undergoing TAVR compared to SAVR?
Hyperspectral imaging can successfully detect microcirculatory changes during cardiac surgery, demonstrating that cardiopulmonary bypass duration negatively impacts tissue oxygenation.
HSI may differentiate microcirculatory effects of SAVR versus TAVR; hypothesis-generating and requires prospective validation before clinical adoption.
This prospective, observational study evaluated Hyperspectral Imaging (HSI) to assess the effects of cardiac surgery and cardiopulmonary bypass (CPB) on microcirculation. 40 Patients with severe aortic stenosis were enrolled. 20 patients underwent transapical/transaxillary/transaortic aortic valve replacement (TAVR), 20 underwent an open surgical approach with CPB (SAVR). HSI was used to determine tissue oxygenation (StO2 and NIR), hemoglobin (THI) and water content (TWI) at the palm before/after surgery (T1/T2), and on the third postoperative day (T3). TAVR patients showed no significant changes of microcirculatory parameters during surgery. TWI significantly increased until T3. SAVR patients showed an increase of TWI and a decrease of THI, while StO2 and NIR remained unchanged at T2. In SAVR patients, StO2 and NIR correlated negatively with the duration of CPB and StO2 correlated with intraoperative urine output at T2. HSI was able to detect microcirculatory changes during cardiac surgery. CPB duration seemed to affect tissue oxygenation. Clinical trial registration: (German Clinical Trial Register): DRKS00024765.
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Dietrich et al. (2024) conducted an observational in Severe aortic stenosis (n=40). Surgical aortic valve replacement with cardiopulmonary bypass vs. Transcatheter aortic valve replacement was evaluated on Perioperative changes of HSI derived tissue oxygenation (StO2 and NIR), hemoglobin (THI) and water content (TWI) from preoperative to postoperative. Surgical aortic valve replacement with cardiopulmonary bypass significantly increased tissue water content and decreased tissue hemoglobin content, whereas transcatheter replacement caused no significant microcirculatory changes.
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