Background and Goal of Study
Cardio-protective effect of volatile anaesthetic agencies is shown in some setting of cardiac surgery, although, is not uncertain in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study is to reveal whether desflurane decreases postoperative myocardial injury in patients who undergo TAVI under general anaesthesia.

Materials and Methods
This is a retrospective study undertaken after the institutional review board approval. We derived anaesthetic details and perioperative blood test values from electric hospital records in patients who underwent TAVI with femoral approach under general anaesthesia in a single university hospital in 2015. We determined that postoperative myocardial injury was represented by peak creatine kinase myocardial band (CK-MB) and troponin I (TnI) values within postoperative 72 hours referring the Valve Academic Research Consortium-2 consensus. We compared these values between patients in whom general anaesthesia was maintained with desflurane (GroupD) and those with propofol (GroupP).

Results and Discussion
Ninety patients were included in the final analysis. Peak CK-MB was 9.25 [1.3-20.3] ng/mL (median [range]) in GroupD (n=26) and 8.7 [2.6-49.7] in GroupP (n=64), P=0.52. Peak TnI either did not show statistically significant difference between groups; 1.233 [0.088-6.347] and 1.244 [0.036-29.0] ng/mL (GroupD and GroupP, P=0.71). . Desflurane showed no superiority to propofol with regard to myocardial protection in our study population. The rate of patients who developed postoperative myocardail injury was comparable between groups (Group D: 76.9 to Group P: 68.8 %).

Conclusions
Desflurane did not decrease postoperative myocardial injury in patients undergoing TAVI with femoral approach under general anaesthesia. Large scale randomized controlled trial is desirable in the future including different settings; other surgical approach of TAVI or use of sevoflurane.

Desflurane does not decrease the risk of myocardial injury in trans-catheter aortic valve implantation with the trans-femoral approach under general anaesthesia