September 20, 2011Anaesthesia
Transfemoral aortic valve implantation under sedation and monitored anaesthetic care – a feasibility study
Why the study?
Does sedation with remifentanil and midazolam allow safe performance of transfemoral transcatheter aortic valve implantation in older patients at high risk for surgery?
Population
n=100 older patients at high risk for surgery with symptomatic aortic valve stenosis, mean age 80 years.
Design
Case_series
Follow-up
1 year
Authors
Discussion
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Member takes
Implication
May support sedation for most high-risk transfemoral TAVI cases; leaves open need for randomized confirmation of safety.
Structured PICO
Does sedation with remifentanil and midazolam allow safe performance of transfemoral transcatheter aortic valve implantation in older patients at high risk for surgery?
P
Population
n=100 older patients at high risk for surgery (predicted surgical mortality 21.6%) with symptomatic aortic valve stenosis, mean age 80 years.
I
Intervention
Sedation with remifentanil infusion (0-0.2 μg.kg(-1).min(-1)) and midazolam (1-3 mg) as required, with monitored anaesthetic care during transfemoral transcatheter aortic valve implantation.
O
Outcome
Feasibility and safety (conversion to general anaesthesia, 30-day and 1-year all-cause mortality)safety
Transfemoral transcatheter aortic valve implantation can be safely performed under sedation and monitored anaesthetic care in the majority of high-risk patients, avoiding the need for general anaesthesia.
Cite This Study
Bergmann et al. (2011) studied this question.