Anaesthetic management of transcatheter aortic valve implantation: results from the Italian CoreValve registry

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Anna Sonia PetronioFederica Ettori

Abstract

Transcatheter aortic valve implantation (TAVI) represents a valid therapeutic alternative for patients with severe aortic stenosis at high surgical risk. However, there is no general consensus regarding the role of anaesthesia in TAVI management. The goal of this clinical project was to assess the safety and non-inferiority of local anaesthesia (LA) versus general anaesthesia (GA) in a large cohort of patients undergoing TAVI. All 1,316 consecutive patients who underwent TAVI at seven high-volume Italian centres were enrolled. The anaesthetic regimen consisted of GA in 355 (26.9%) patients or LA in 961 (73.0%) patients. Baseline demographics were similar between the two groups except for a higher median logistic EuroSCORE (p=0.004) and peripheral artery disease (p<0.001) in the GA group. The two groups showed similar device success with no significant difference in terms of mortality, stroke and myocardial infarction. The overall procedural time was longer with the use of GA (p<0.001). The LA group showed a lower incidence of major access-site complications (p=0.01) and major (p=0.03) and life-threatening bleedings (p<0.001) with a lower occurrence of acute kidney injury stage 3 (p=0.002). Consistently, we observed a significan...Continue Reading

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Citations

Jul 30, 2015·Therapeutic Hypothermia and Temperature Management·David J L ZughaftMatthias Götberg
Sep 19, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Peter F Ludman, Ron Van Domburg
Jan 24, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Patrick HornRalf Westenfeld
Sep 26, 2015·Seminars in Cardiothoracic and Vascular Anesthesia·Fabio Guarracino, Rubia Baldassarri
Jul 25, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Pedro A VillablancaHarish Ramakrishna
Mar 31, 2018·Heart·Mehdi EskandariUNKNOWN UK TAVI Steering Committee and the National Institute for Cardiovascular Outcome Research
Jul 3, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Riccardo LigaAnna Sonia Petronio
Feb 13, 2016·Journal of Interventional Cardiology·Kishore J HarjaiMartin B Leon
Oct 11, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Ralf Felix TrauzeddelSascha Treskatsch
Jun 9, 2021·Pacing and Clinical Electrophysiology : PACE·Juntao WangJing-Quan Zhong
Jul 13, 2021·Brazilian Journal of Anesthesiology·Gönül ErkanLevent Korkmaz

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