Conscious sedation for percutaneous LAAO reduced procedural time by 11.95 minutes and contrast volume by 31.90 mL compared to general anesthesia without compromising outcomes.
Does conscious sedation improve procedural characteristics and safety compared to general anesthesia in patients undergoing percutaneous left atrial appendage occlusion?
Conscious sedation for percutaneous LAAO reduces procedural time and contrast volume without compromising device success or clinical safety compared to general anesthesia.
Absolute Event Rate: 0% vs 0%
ABSTRACT Background Percutaneous left atrial appendage occlusion (LAAO) has traditionally been performed under general anesthesia (GA) to maintain patient comfort and immobility, especially in the setting of transesophageal echocardiography. Aims We aimed to compare the safety and efficacy of conscious sedation (CS) compared to GA for LAAO, concurrent with the expansion of intracardiac echocardiography guidance. Methods A systematic search of the PubMed, Embase, Cochrane Central, and Scopus databases was conducted through December 2024 for studies comparing CS versus GA for LAAO. For outcomes of procedural complications and characteristics, random‐effects models were used to calculate the mean difference (MD), odds ratio (OR), and risk ratio (RR) effect estimates with 95% confidence intervals (CIs). Results Four studies with 1540 patients undergoing LAAO were included (CS = 678, GA = 862). CS was associated with significantly shorter total procedural time MD −11.95 min; 95% CI −19.52 to −2.78; p = 0.009 and a lower volume of contrast media MD −31.90 mL; 95% CI −56.72 to −7.08; p = 0.01. No significant differences were noted for total fluoroscopy time, total length of hospital stay, device success, all‐cause mortality, cardiovascular mortality, stroke, device‐related thrombus, and peri‐device leak > 5 mm. Conclusion Percutaneous LAAO using CS allows for faster procedures and lower contrast media volumes compared to GA without compromising device success and clinical outcomes. Randomized studies with longer follow‐ups are necessary to understand the long‐term outcomes of percutaneous LAAO using CS.
Jain et al. (Wed,) reported a other. Conscious sedation for percutaneous LAAO reduced procedural time by 11.95 minutes and contrast volume by 31.90 mL compared to general anesthesia without compromising outcomes.