TAVR outcomes similar after conscious sedation and general anesthesia
Conscious sedation (CS) can safely be used when patients with aortic stenosis undergo transfemoral transcatheter aortic valve replacement (TAVR) procedures, according to a new analysis published in Circulation.
The study’s authors used findings from the SOLVE-TAVI trial for their research, tracking the outcomes of more than 400 patients treated at one of seven German facilities. All patients were 75 years old or older and underwent transfemoral TAVR from April 6, 2016, to April 16, 2018. While 222 patients were treated with CS, another 225 patients were treated with general anesthesia (GA).
The researchers compared the outcomes associated with CS and GA, looking at all-cause mortality, stroke, myocardial infarction, infection requiring antibiotics and acute kidney injury after 30 days.
Overall, CS and GA led to “similar outcomes” in all categories. All-cause mortality after 30 days, for example, was 3.2% for CS and 2.3% for GA. The stroke rate after 30 days was 2.4% for CS and 2.8% for GA.
“These findings suggest that both anesthesia strategies can be used in clinical practice for the treatment of high- to intermediate-risk patients with severe aortic stenosis undergoing TAVR,” wrote lead author Holger Thiele, MD, director of cardiology at Leipzig University Hospital in Germany, and colleagues. “Consequently, patient factors and preference as well as center and operator experience should play a major role in the decision-making regarding the optimal anesthetic type.”
Funding for the team’s research was provided by the German Heart Research Foundation and Leipzig Heart Institute. The full analysis is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.