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

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 (P = 0.83).Our analyses found no significant major outcome differences between CS and GA during TAVI.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:61

Enthalten in:

International heart journal - 61(2020), 4 vom: 30. Juli, Seite 713-719

Sprache:

Englisch

Beteiligte Personen:

Neumann, Franz-Josef [VerfasserIn]
Redwood, Simon [VerfasserIn]
Abdel-Wahab, Mohamed [VerfasserIn]
Lefèvre, Thierry [VerfasserIn]
Frank, Derk [VerfasserIn]
Eltchaninoff, Hélène [VerfasserIn]
Caussin, Christophe [VerfasserIn]
Stella, Pieter R [VerfasserIn]
Hovorka, Tomas [VerfasserIn]
Baumgartner, Helmut [VerfasserIn]
Tarantini, Giuseppe [VerfasserIn]
Wendler, Olaf [VerfasserIn]
Treede, Hendrik [VerfasserIn]
SOURCE 3 Investigators [VerfasserIn]

Links:

Volltext

Themen:

Aortic stenosis
Balloon-expandable transcatheter heart valve
Comparative Study
Journal Article
SOURCE 3 Registry

Anmerkungen:

Date Completed 12.08.2020

Date Revised 12.08.2020

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1536/ihj.19-567

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM312609027