Year : 2019  |  Volume : 22  |  Issue : 3  |  Page : 239--245

Chronic postthoracotomy pain in transapical transcatheter aortic valve replacement


Brian R Gebhardt1, Ankit Jain1, Sarah A Basaham2, Farhad Zahedi1, Stefan Ianchulev1, Larry H Brinckerhoff3, John G Augoustides4, Prakash A Patel5, Andrea Tsai1, Frederick C Cobey1 
1 Department of Anesthesiology, Tufts Medical Center, Boston, MA, USA
2 Department of Anesthesiology, Tufts Medical Center, Boston, MA, USA; Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
3 Department of Surgery, Tufts Medical Center, Boston, MA, USA
4 Cardiovascular and Thoracic Section Anesthesiology and Critical Care, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
5 Department of Anesthesiology, University of Pennsylvania, Philadelphia, PA, USA

Correspondence Address:
Frederick C Cobey
Department of Anesthesiology, Tufts Medical Center, 800 Washington St., Boston, MA 02111
USA

Objective: Chronic postthoracotomy pain (CPTP) is a persistent, occasionally debilitating pain lasting >2 months following thoracic surgery. This study investigates for the first time the prevalence and clinical impact of CPTP in patients who have undergone a transapical transcatheter aortic valve replacement (TA-TAVR). Design: This was a single-institution, prospective observational survey and a retrospective chart review. Setting: The study was conducted in the University Hospital. Participants: Patients. Materials and Methods: A survey of 131 participants with either a previous TA TAVR or transfemoral (TF) TAVR procedure was completed. A telephone interview was conducted at least 2 months following TAVR; participants were asked to describe their pain using the Short-Form McGill Pain Questionnaire. Measurements and Main Results: Odds ratio (OR) was calculated using the proportions of questionnaire responders reporting “sensory” descriptors in the TA-TAVR versus the TF-TAVR groups. Results were then compared to individual Kansas City Cardiomyopathy Questionnaire (KCCQ12) scores and 5-min walk test (5MWT) distances. A total of 119 participants were reviewed (63 TF, 56 TA). Among TA-TAVR questionnaire responders (n = 16), CPTP was found in 64.3% of participants for an average duration of 20.5-month postprocedure (OR = 10, [confidence interval (CI) 95% 1.91–52.5];P = 0.003). TA-TAVR patients identified with CPTP had significant reductions in 5MWT distances (−2.22 m vs. 0.92 m [P = 0.04]) as well as trend toward significance in negative change of KCCQ12 scores OR = 18.82 (CI 95% 0.85–414.99;P = 0.06) compared to those without CPTP. Conclusions: CPTP occurs in patients undergoing TA-TAVR and is possibly associated with a decline quality of life and overall function.


How to cite this article:
Gebhardt BR, Jain A, Basaham SA, Zahedi F, Ianchulev S, Brinckerhoff LH, Augoustides JG, Patel PA, Tsai A, Cobey FC. Chronic postthoracotomy pain in transapical transcatheter aortic valve replacement.Ann Card Anaesth 2019;22:239-245


How to cite this URL:
Gebhardt BR, Jain A, Basaham SA, Zahedi F, Ianchulev S, Brinckerhoff LH, Augoustides JG, Patel PA, Tsai A, Cobey FC. Chronic postthoracotomy pain in transapical transcatheter aortic valve replacement. Ann Card Anaesth [serial online] 2019 [cited 2019 Sep 24 ];22:239-245
Available from: http://www.annals.in/article.asp?issn=0971-9784;year=2019;volume=22;issue=3;spage=239;epage=245;aulast=Gebhardt;type=0