Less invasive anesthesia strategies during TAVR linked to a key benefit
Different anesthesia strategies are associated with similar long-term transcatheter aortic valve replacement (TAVR) outcomes, according to new real-world data published in the Journal of Clinical Anesthesia.[1] When it comes to short-term outcomes, however, choosing regional anesthesia or moderate sedation is associated with a lower risk of all-cause hospital readmission than general anesthesia (GA).
“As TAVR adoption continues to expand globally, increasing attention has shifted toward optimizing peri-procedural care to enhance recovery, maintain procedural safety and improve healthcare efficiency,” wrote first author Mahmoud S. Mohamed, MD, a researcher with Case Western Reserve University School of Medicine, and colleagues. “Anesthetic strategy represents a key component of peri-procedural management during TAVR. Contemporary practice varies widely between the use of GA and non-general anesthesia (NGA).”
Mohamed et al. tracked real-world data from TAVR patients treated from 2015 to 2024. All data came from the TriNetX Global Collaborative Network. Using propensity score matching, the group focused on two groups of 1,793 patients—one group that underwent TAVR with GA and another that underwent TAVR with NGA, defined as regional anesthesia or moderate sedation.
Overall, rates of all-cause mortality, stroke, myocardial infarction, acute kidney injury, atrial fibrillation and major vascular complications were all comparable between the two groups after 30 days, 90 days and one year. The heart failure rate after one year was slightly higher for the GA group, the authors noted, but it was not statistically significant.
One key difference was identified after 30 days. Patients treated with regional anesthesia or moderate sedation were linked to a lower hospital readmission rate than those treated with GA.
“These findings highlight that while anesthetic strategy may not impact long-term survival, the choice of anesthesia may influence early postoperative recovery and healthcare resource utilization,” the authors wrote. “Our findings align with a growing body of evidence suggesting that less invasive anesthetic approaches may be safe and effective for TAVR, particularly in contemporary practice where procedural techniques and devices have evolved toward minimal invasiveness.”
The group did note that this improvement in hospital readmission for NGA patients should be seen as a hypothesis-generating finding and not “definitive evidence of a causal effect.”
“Future prospective studies capturing length of stay, discharge planning, and early post-discharge care will be essential to clarify the mechanisms underlying this early benefit and to determine whether it reflects a true physiologic advantage of NGA or downstream differences in perioperative care processes,” they wrote.
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.