Assessment of Cardiac Biomarkers Following Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis

Transcatheter aortic valve implantation (TAVI) has emerged as a transformative intervention for patients with severe aortic stenosis (AS), particularly those deemed high-risk for open surgery. The hemodynamic and biochemical responses following TAVI remain a critical area of investigation, especially in the context of perioperative management strategies that may modulate myocardial stress and injury. This experimental study aimed to evaluate the influence of sub-anesthetic dosing of ketamine on post-procedural cardiac biomarker profiles, including high-sensitivity troponin T (hs-TnT), creatine kinase-MB (CK-MB), and N-terminal pro B-type natriuretic peptide (NT-proBNP), in patients undergoing TAVI. A total of 84 patients were randomly divided into two groups: a sub-anesthetic ketamine group (0.3 mg/kg bolus followed by 0.1 mg/kg/h infusion) and a standard sedation group without ketamine. Biomarker levels were measured preoperatively, and at 6 and 24 hours post-procedure. Results revealed statistically significant reductions in hs-TnT and NT-proBNP levels in the ketamine group at both time points (p<0.001), suggesting reduced myocardial injury and stress. No significant difference in CK-MB was observed between the groups. These findings underscore the cardioprotective potential of sub-anesthetic ketamine in mitigating biochemical injury following TAVI. This study introduces a novel adjunctive strategy to optimize TAVI outcomes by leveraging sub-anesthetic modulation of perioperative myocardial stress.