General Anesthesia or Conscious Sedation for Transfemoral Aortic Valve Replacement with the SAPIEN 3 Transcatheter Heart Valve

International Heart Journal
Franz-Josef NeumannSOURCE 3 Investigators

Abstract

Differences in the benefits of conscious sedation (CS) and general anesthesia (GA) during transfemoral aortic valve implantation (TAVI) are unclear.We aimed to assess differences in procedural and clinical outcomes based on the type of anesthesia received during TAVI.We analyzed SOURCE 3 Registry data for patients who received the SAPIEN 3 valve by type of anesthesia used during TAVI.Of the 1694 TAVI patients, 1027 received CS and 667 received GA. Patients were similar at baseline (81.5 years; Society of Thoracic Surgeons risk score 7.0). Compared with the GA group, the CS group had fewer intra-procedural transesophageal echocardiography (TEE) and post implantation dilatations performed, and less contrast medium was used. The CS group had significantly less kidney injury at 7 days post-procedure than the GA group (0.4% versus 1.5%, P = 0.014). Moderate paravalvular leaks (PVL) occurred more frequently in the CS group versus the GA group (2.2% versus 0.8%; P = 0.041). No severe PVL were reported. Median total hospital length of stay (LOS) after TAVI was 10 days in the CS group and 11 days in the GS group. At 30 days, all-cause death was 2.1% in CS and 1.7% in GS (P = 0.47), and myocardial infarction was 0.2% in CS and 0.1% in GS...Continue Reading

References

Nov 21, 2008·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Miles BehanDavid Hildick-Smith
Sep 21, 2011·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Lukas J MotlochUta C Hoppe
Jul 24, 2012·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Itsik Ben-DorRon Waksman
Dec 3, 2014·International Journal of Cardiology·Gianni Dall'AraUNKNOWN Transcatheter Valve Treatment Sentinel Registry (TCVT) Investigators of the EurObservational Research Programme (EORP) of th
Feb 20, 2016·The American Journal of Cardiology·Stephen J D BreckerUNKNOWN ADVANCE Study Investigators
Aug 9, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Paola D'ErrigoUNKNOWN OBSERVANT Research Group

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