July 24, 2017Catheterization and Cardiovascular Interventions
Comparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta‐analysis
Key result
Local anesthesia for TAVR was associated with lower overall 30-day mortality compared to general anesthesia (RR 0.73; 95% CI 0.57-0.93; P=0.01).
Why the study?
Does local anesthesia/conscious sedation reduce 30-day mortality and improve procedural metrics compared to general anesthesia in patients undergoing TAVR?
Population
10,572 patients with severe aortic stenosis undergoing transcatheter aortic valve replacement pooled from 26…
Comparison
Local anesthesia/conscious sedation (LA) vs General anesthesia (GA)
Design
Meta-analysis
Follow-up
30-day
Authors
Discussion
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Implication
Supports LA/conscious sedation as viable alternative to GA for TAVR; reinforces consensus from prior RCTs and observational data.
Study Design
Type
Meta-Analysis (n=10,572)
Structured PICO
Does local anesthesia/conscious sedation reduce 30-day mortality and improve procedural metrics compared to general anesthesia in patients undergoing TAVR?
P
Population
10,572 patients with severe aortic stenosis undergoing transcatheter aortic valve replacement across 26 studies.
I
Intervention
Local anesthesia/conscious sedation (LA)
C
Comparator
General anesthesia (GA)
O
Outcome
Overall 30-day mortalityhard clinical
Main Result
Relative Risk: 0.73 (95% CI 0.57–0.93)
p-value: p=0.01
Local anesthesia/conscious sedation for TAVR is associated with lower 30-day mortality, shorter hospital stays, and reduced need for inotropic support compared to general anesthesia, without increasing procedural complications.
Cite This Study
Villablanca et al. (2017) conducted a meta-analysis in Severe aortic stenosis undergoing TAVR (n=10,572). Local anesthesia/conscious sedation (LA) vs. General anesthesia (GA) was evaluated on Overall 30-day mortality (RR 0.73, 95% CI 0.57-0.93, p=0.01). Local anesthesia for TAVR was associated with lower overall 30-day mortality compared to general anesthesia (RR 0.73; 95% CI 0.57-0.93; P=0.01).