心尖部アプローチによる経カテーテル大動脈弁留置術において術野でX線透視下持続胸部傍脊椎ブロックを施行した一症例

We report a novel technique of thoracic paravertebral block in transapical transcatheter aortic valve implantation. Radiopaque catheter for continuous paravertebral block was placed by the surgeon via guiding sheath inserted to the paravertebral space from posterior intercostal wound margin. Fluoroscopy was used for guidance of the sheath and the catheter. Postoperative course was uneventful with adequate pain control. We consider this technique can be useful for perioperative pain management in transapical transcatheter aortic valve implantation.