Focus on valvular heart disease

Lancellotti, Patrizio; Petitjean, Hélène; Postolache, Adriana; Cosyns, Bernard

doi:10.1080/00015385.2022.2159193

Cited by 7 publications

(1 citation statement)

References 20 publications

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“…Nonetheless, a few authors discovered an increased shortterm death rate in the GA group (14,15). Due to the design of these investigations, the baseline disparities among the two groups, and the frequent application of GA in nations like the United States, it is possible that disparities are the result of biased selection (16).…”

Section: Discussionmentioning

confidence: 99%

Local against general anesthesia for transcatheter aortic valve replacement

Günlü

Kayan

Güzel

et al. 2023

HTD

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Background/Aims: Transcatheter aortic valve replacement (TAVR) poses significant challenges concerning anesthesia management. There is no consensus on the type of safer anesthesia for TAVR procedures. We aimed to evaluate the effectiveness and safety of TAVR performed with trans-femoral approach under local anesthesia with sedation (LAS) against general anesthesia (GA). Methods: This observational and retrospective analysis included individuals who were admitted on a planned basis from 2016 to 2022 and underwent Transfemoral TAVR. Effectiveness and safety outcomes were evaluated at 30 days. İndividuals were separated into two groups: GA and LAS. Demographic characteristics and procedural data were recorded during hospitalization. Results: 115 patients were included, of whom 62 (53.9%) received LAS and 53 received GA (46.1%). 59 female (48.8%) patients with a mean age of 83.2±5.7 participated in the study. Successful TAVR procedure was performed in 100 (86.9%) of 115 patients with the transfemoral approach. The mean procedure time was 136.7±46.7 minutes, and the procedure time was shorter in patients who underwent LAS against GA (p=0.001). There were no differences among the groups including fluoroscopy time, contrast, and radiation dose (p>0.05). In 2 patients (3.2%), significant vascular complications necessitated immediate surgical intervention, necessitating a change in the anesthesia technique. Overall 30-day mortality was 5.2%, with no significant differences among the groups (GA 7.5% vs. LAS 3.2%, p =0.28). GA had substantially longer ICU and total hospitalization stays than LAS (p=0.009 and p =0.004, respectively). Conclusions: In our study, TAVR via the transfemoral route using LAS was an alternative for GA.

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Section: Discussionmentioning

confidence: 99%