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Left Subclavian Transcatheter Aortic Valve Replacement Under Combined Interscalene and Pectoralis Nerve Blocks

A Case Series

Block, Michael, MD*; Pitchon, Darsi N., MD*; Schwenk, Eric S., MD*; Ruggiero, Nicholas, MD; Entwistle, John, MD; Goldhammer, Jordan E., MD*

doi: 10.1213/XAA.0000000000000819
Case Reports
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The treatment for aortic stenosis is evolving rapidly with new developments in transcatheter aortic valve replacement (TAVR). While the procedure was initially performed under general anesthesia with invasive monitoring and transesophageal echocardiography, recent trends have shifted toward less invasive strategies. Transfemoral TAVRs are frequently performed under sedation; however, TAVRs using alternative access sites, such as the subclavian artery, are typically performed under general anesthesia. This case series describes 3 patients who underwent subclavian TAVR under combined pectoralis and interscalene blocks. All patients tolerated the procedure without complication, requiring no airway manipulation and minimal postoperative analgesia.

From the *Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania

Department of Cardiology, Division of Interventional Cardiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania

Department of Surgery, Division of Cardiothoracic Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.

Accepted for publication May 8, 2018.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Address correspondence to Jordan E. Goldhammer, MD, Department of Anesthesiology, Thomas Jefferson University Hospital, 111 S 11th St, Suite 8280, Philadelphia, PA 19107. Address e-mail to Jordan.Goldhammer@jefferson.edu.

© 2018 International Anesthesia Research Society
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