Isolated local anesthesia for transcatheter aortic valve implantation was reported as noninferior to conscious sedation for 30-day outcomes, but high crossover rates challenge clinical equivalence.
Does local anesthesia alone prevent mortality, complications, and neurologic events compared to conscious sedation in patients undergoing transcatheter aortic valve implantation?
Editorialists caution against adopting local anesthesia alone for TAVI due to high crossover rates and increased patient pain and anxiety, despite noninferiority in hard clinical outcomes.
Amacher et al. (Fri,) conducted a letter in Transcatheter aortic valve implantation (TAVI). Isolated local anesthesia vs. Conscious sedation was evaluated on Composite of all-cause mortality, vascular and bleeding complications, infections requiring antibiotics, and neurologic events at 30 days. Isolated local anesthesia for transcatheter aortic valve implantation was reported as noninferior to conscious sedation for 30-day outcomes, but high crossover rates challenge clinical equivalence.