August 21, 2020Circulation
General Versus Local Anesthesia With Conscious Sedation in Transcatheter Aortic Valve Implantation
Why the study?
Local anesthesia with conscious sedation is commonly used in transcatheter aortic valve replacement, but randomized data comparing its safety and efficacy with general anesthesia were lacking.
Does local anesthesia with conscious sedation result in equivalent outcomes compared to general anesthesia in patients with aortic stenosis undergoing transfemoral transcatheter aortic valve replacement?
Population
447 patients with aortic stenosis undergoing transfemoral transcatheter aortic valve replacement
Comparison
Conscious sedation vs general anesthesia
Design
Multicenter open-label 2x2 factorial randomized equivalence trial
Follow-up
30 days
Authors
Discussion
Loading...
Member takes
Implication
Conscious sedation is equivalent to general anesthesia for the primary composite in transfemoral TAVR; confirms equivalence and supports preference to reduce inotrope/vasopressor needs.
Structured PICO
Does local anesthesia with conscious sedation result in equivalent outcomes compared to general anesthesia in patients with aortic stenosis undergoing transfemoral transcatheter aortic valve replacement?
P
Population
447 patients with aortic stenosis undergoing transfemoral transcatheter aortic valve replacement
I
Intervention
Local anesthesia with conscious sedation (CS)
C
Comparator
General anesthesia (GA)
O
Outcome
Composite of all-cause mortality, stroke, myocardial infarction, infection requiring antibiotic treatment, and acute kidney injury at 30 dayscomposite
In patients undergoing transfemoral TAVR, conscious sedation is equivalent to general anesthesia regarding a 30-day composite of mortality, stroke, MI, infection, and AKI, and is associated with a lower need for inotropes or vasopressors.
Cite This Study
Thiele et al. (2020) studied this question.