September 1, 2015Open Access
Sedation or general anesthesia for transcatheter aortic valve implantation (TAVI).
Why the study?
Does conscious sedation compared to general anesthesia improve outcomes in elderly patients undergoing TAVI?
Population
6,718 elderly patients with severe aortic stenosis and high perioperative risk undergoing transcatheter…
Comparison
Conscious sedation (TAVI-S) (n=3,227) vs General anesthesia (TAVI-GA)
Design
Review
Follow-up
short and long-term
Authors
Discussion
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Member takes
Implication
Similar TAVI mortality with either approach; high conversion rates leave open optimal strategy and team requirements.
Structured PICO
Does conscious sedation compared to general anesthesia improve outcomes in elderly patients undergoing TAVI?
P
Population
6,718 elderly patients with severe aortic stenosis (AS) and high perioperative risk undergoing transcatheter aortic valve implantation (TAVI) across 13 non-randomized studies/registries.
I
Intervention
Conscious sedation (TAVI-S) (n=3,227)
C
Comparator
General anesthesia (TAVI-GA)
O
Outcome
In-hospital and longer-term mortalityhard clinical
Conscious sedation and general anesthesia for TAVI yield similar mortality outcomes, but the high rate of unplanned conversion to general anesthesia highlights the need for an experienced cardiac anesthetist during TAVI-S.
Limitations
- No randomized trial data exists
- Patient selection, study methods, and endpoints differed considerably between published studies
Cite This Study
Mayr et al. (2015) studied this question.