Hemodynamic Safety of Dexmedetomidine-Fentanyl Sedation During TAVI

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established alternative for patients with severe aortic stenosis who are unsuitable for surgical valve replace-ment. Conscious sedation is preferred to preserve spontaneous respiration and patient cooperation. Dexmedetomidine, a selective α2-adrenergic agonist, provides sedation, analgesia, and sympatholysis with minimal respiratory depression, making it suitable for high-risk TAVI patients. METHODS: We retrospectively analyzed 53 patients who underwent TAVI under dexme-detomidine-based sedation at a single center between January and July 2025. Patients received an initial loading dose of dexmedetomidine (1 μg/kg over 15 minutes) and fen-tanyl (1 μg/kg), followed by dexmedetomidine infusion (0.2-1.2 μg/kg/h) to achieve a Ramsay Sedation Score of 3-4 and bispectral index (BIS) 70-80. Hemodynamic param-eters were recorded at baseline (T0), post-loading (T1), 10 minutes post-loading (T2), and end of procedure (T3). Hemodynamic compromise was defined as a >30% decrease in systolic or mean arterial pressure(MAP)