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Noninvasive ventilation (NIV) can be used in heart failure patients to improve both their cardiac and respiratory status. The use of positive airway pressure in heart failure patients with valvular heart disease has unique physiologic implications. It can reduce preload, improve oxygenation, reduce LV afterload, and has a variable effect on RV afterload. The net hemodynamic effect of NIV depends on whether the patient is in an afterload or preload-dependent state based on underlying valvular heart disease. NIV is also useful in patients with comorbidities such as obstructive sleep apnea, orthopnea, and COPD who are undergoing various structural heart procedures; other oxygen delivery devices, such as nasal cannulas or venturi masks, may not be effective in these scenarios. Transcatheter aortic valve replacement (TAVR), transcatheter edge-to-edge repair (TEER) of the mitral valve (MitraClip), transcatheter mitral valve replacement, and left atrial appendage (LAA) closure devices are all examples of procedures where NIV has been successfully used to avoid general anesthesia and the associated risks.

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Noninvasive Mechanical Ventilation (NIV) in Valvular Heart Disease and Left Atrial Occlusion Procedures

  • 章节

  • 发表日期：

    2025年

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  • Fallon France,
  • Daniel Rubinger,
  • Ravie Abozaid,
  • Kunal Panda

摘要

Noninvasive ventilation (NIV) can be used in heart failure patients to improve both their cardiac and respiratory status. The use of positive airway pressure in heart failure patients with valvular heart disease has unique physiologic implications. It can reduce preload, improve oxygenation, reduce LV afterload, and has a variable effect on RV afterload. The net hemodynamic effect of NIV depends on whether the patient is in an afterload or preload-dependent state based on underlying valvular heart disease. NIV is also useful in patients with comorbidities such as obstructive sleep apnea, orthopnea, and COPD who are undergoing various structural heart procedures; other oxygen delivery devices, such as nasal cannulas or venturi masks, may not be effective in these scenarios. Transcatheter aortic valve replacement (TAVR), transcatheter edge-to-edge repair (TEER) of the mitral valve (MitraClip), transcatheter mitral valve replacement, and left atrial appendage (LAA) closure devices are all examples of procedures where NIV has been successfully used to avoid general anesthesia and the associated risks.