General Anesthesia Versus Monitored Anesthesia Care for Transfemoral Transcatheter Aortic Valve Implantation: A Retrospective Study in a Single Belgian Referral Center

Stragier, Hendrik; Dubois, Christophe; Verbrugghe, Peter; Jacobs, Steven; Adriaenssens, Tom; Rex, Steffen

doi:10.1053/j.jvca.2019.06.027

Cited by 15 publications

(15 citation statements)

References 18 publications

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“…However, hospital length of stay was significantly shorter in the MAC cohort when compared with the GA cohort (2.68 v 3.75 days, p < 0.001), consistent with other major studies. 6,7 This study also found no significant difference in 30-day mortality. This notably differed from the large multicenter analysis by Hyman et al, which found "conscious sedation" was associated, with a lower 30-day mortality in their propensity-matched study.…”

mentioning

confidence: 43%

Anesthesiology Research Using Surgical Registries: Consider the Source

Nampi

Law

Neuburger

2021

Journal of Cardiothoracic and Vascular Anesthesia

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mentioning

confidence: 43%

Anesthesiology Research Using Surgical Registries: Consider the Source

Nampi

Law

Neuburger

2021

Journal of Cardiothoracic and Vascular Anesthesia

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“…7 Furthermore, procedural outcomes did not significantly differ between GA and MAC. 7 Since then, MAC supplemented with a local or regional anesthesia has gained increasing popularity for transcatheter cardiovascular procedures. 7 Many institutions recently have been using MAC to treat patients with intracranial aneurysm (IA), with coils and/or stents, including the Pipeline embolization device (EV3, Irvine, CA, USA).…”

Section: Introductionmentioning

confidence: 87%

“…7 Since then, MAC supplemented with a local or regional anesthesia has gained increasing popularity for transcatheter cardiovascular procedures. 7 Many institutions recently have been using MAC to treat patients with intracranial aneurysm (IA), with coils and/or stents, including the Pipeline embolization device (EV3, Irvine, CA, USA). 8,9 MAC can be effectively performed in most patients who underwent endovascular treatments for ruptured [10][11][12] as well as unruptured [10][11][12][13] IAs.…”

Section: Introductionmentioning

confidence: 99%

Safety and feasibility of the Woven EndoBridge device deployment with monitored anesthesia care

Ishii

Zanaty

et al. 2020

Interv Neuroradiol

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Objective The Woven EndoBridge (WEB) device can be used for complex intracranial aneurysms (IAs), mostly under general anesthesia (GA). However, it remains controversial if anesthetic management could affect procedural outcomes after endovascular treatments using the WEB for IAs. The purpose of this study is to investigate the safety and feasibility of the WEB deployment for patients under monitored anesthesia care (MAC). Methods We reviewed 27 IAs in 25 patients who were treated by using the WEB device from February to December in 2019. Our first-line anesthetic management of patients during the procedures was the MAC. GA was performed based on patient’s clinical status or preference. Subjects’ demographic data, aneurysms’ characteristics, procedure-related complications, grade of stasis after the WEB deployment, duration of procedure, and length of hospital stay were compared between subjects who underwent GA versus those who underwent MAC. Results Successful deployment of the WEB device was obtained in all patients. In total, 10 and 17 IAs were treated with GA and MAC, respectively. There was no significant difference in demographics (age: p = 0.12, sex: p = 0.54), aneurysms’ characteristics (ruptured: p = 1.00, neck width: p = 0.96, aspect ratio: p = 0.98, maximum diameter: p = 0.69), complications ( p = 1.00), postprocedural grade of stasis ( p = 1.00), duration of the procedure ( p = 0.23), and the length of hospital stay ( p = 0.81) between GA and MAC. Conclusions MAC can be used for the WEB device deployment safely and effectively.

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“…The remaining 21 full-text studies were reviewed for more detailed assessment of which 4 studies were excluded by the reasons of not reporting both LA and GA, as shown in Figure 1. At last, 17 articles were included [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”

Section: Study Identification and Selectionmentioning

confidence: 99%

Comparative efficacy of local and general anesthesia for transcatheter aortic valve implantation: a meta-analysis and systematic review

Gao¹,

Jin²,

Chao³

et al. 2021

Preprint

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Background This meta-analysis aimed to compare the potential effects of local anesthesia (LA) and general anesthesia (GA) for transcather aortic value implantation (TAVI). Measurements All relevant studies were searched from the Pubmed, EMbase, Web of Science and the Cochrane Library (January 1, 2016 to June 1, 2021). The main outcomes of this literature meta-analysis were 30-day mortality, procedural time, new pacemaker implantation, total stay in hospital, the use of vasoactive drug, intra-and postoperative complications and emergencies, including conversion to open, myocardial infraction, pulmonary complication, vascular complication, renal injury/failure, stroke, transesophageal echocardiography, life-threatening/major bleeding, cardiac tamponade, emergency PCI. Pooled risk ratio (RR) and mean difference (MD) together with 95% confidence interval (CI) were calculated. Results A total of seventeen studies including 20938 patients in the final analysis fulfilled the inclusion criteria. Intra-and postoperative complications (myocardial infraction, vascular complication, renal injury/failure, stoke, cardiac tamponade) undergoing TAVI in serious AS patients under GA do not offer significant difference compared with LA. No differences are observed between LA and GA for new pacemaker implantation, total stay in hospital, transesophageal echocardiography, emergency PCI. GA is associated with more adverse events, like the more overall mortality (RR 0.69, p=0.600), pulmonary complications (RR 0.54, p=0.278), life-threatening/major bleeding (RR 0.85, p=0.855), the more times of coversion to open (RR 0.22, p=0.746). LA has many advantages, including a shorter procedure duration (MD=-0.38, p=0.000) and a reduction of the use of vasoactive drug (RR 0.57，P=0.000). Conclusions For TAVI, both LA with or without sedation and GA are feasible and safe. LA appears a feasible alternative to GA for AS patients undergo TAVI.

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General Anesthesia Versus Monitored Anesthesia Care for Transfemoral Transcatheter Aortic Valve Implantation: A Retrospective Study in a Single Belgian Referral Center

Cited by 15 publications

References 18 publications

Anesthesiology Research Using Surgical Registries: Consider the Source

Anesthesiology Research Using Surgical Registries: Consider the Source

Safety and feasibility of the Woven EndoBridge device deployment with monitored anesthesia care

Comparative efficacy of local and general anesthesia for transcatheter aortic valve implantation: a meta-analysis and systematic review

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