Conscious sedation versus general anesthesia for transcatheter aortic valve implantation: a retrospective study

Transcatheter Aortic Valve Implantation (TAVI) is recommended in severe aortic stenosis with prohibitive and high surgical risk, and as an alternative in intermediate and low risk patients.1 Despite the growth in the number of procedures, the optimal anesthetic management has not been established.Initially, TAVI was performed almost exclusively under General Anesthesia (GA), but developments in technology, and increase in experience promoted changes in anesthetic technique.At our institution, TAVI was conventionally performed under GA until December 2017, when a Conscious Sedation (CS) protocol was implemented.This protocol became the first line of anesthetic management, unless the patient had considerations to avoid it (difficult airway, poor baseline respiratory status or inability to lie flat, right heart failure, severe pulmonary hypertension, or anticipated vascular access challenges).The objective of this study was to compare the post-interventional outcomes of CS with those of GA in patients undergoing transfemoral TAVI.We conducted a retrospective, single-center, beforeafter study in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.All consecutive patients who underwent