Local Anesthesia versus Conscious Sedation among Patients Undergoing Transcatheter Aortic Valve Implantation-A Propensity Score Analysis.
aortic valve
transcatheter aortic valve implantation
valvular disease
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
31 May 2022
31 May 2022
Historique:
received:
07
04
2022
revised:
03
05
2022
accepted:
18
05
2022
entrez:
10
6
2022
pubmed:
11
6
2022
medline:
11
6
2022
Statut:
epublish
Résumé
Conscious sedation (CS) has been used successfully to treat patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) and as such is considered the standard anesthesia method. The local anesthesia (LA) only approach may be feasible and safe thanks to improvements in operators' experience. To evaluate differences between LA only versus CS approaches on short- and long-term outcomes among patients undergoing TAVI. We performed a propensity score analysis on 1096 patients undergoing TAVI for severe AS. Two hundred and seventy-four patients in the LA group were matched in a ratio of 1:3 with 822 patients in the CS group. The primary outcome was a 1-year mortality rate. Secondary outcomes included procedural and peri-procedural complication rates and in-hospital mortality. Patients in the CS group had significantly higher rates of grade 2-3 acute kidney injury and were more likely to have had new left bundle branch block and high-degree atrioventricular block. Patients who underwent TAVI under CS had significantly higher in-hospital and 1-year mortality rates compared to LA (1.6% vs. 0.0% As compared to CS, the LA-only approach is associated with lower rates of peri-procedural complications and 1-year mortality rates.
Sections du résumé
BACKGROUND
BACKGROUND
Conscious sedation (CS) has been used successfully to treat patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) and as such is considered the standard anesthesia method. The local anesthesia (LA) only approach may be feasible and safe thanks to improvements in operators' experience.
OBJECTIVE
OBJECTIVE
To evaluate differences between LA only versus CS approaches on short- and long-term outcomes among patients undergoing TAVI.
METHODS
METHODS
We performed a propensity score analysis on 1096 patients undergoing TAVI for severe AS. Two hundred and seventy-four patients in the LA group were matched in a ratio of 1:3 with 822 patients in the CS group. The primary outcome was a 1-year mortality rate. Secondary outcomes included procedural and peri-procedural complication rates and in-hospital mortality.
RESULTS
RESULTS
Patients in the CS group had significantly higher rates of grade 2-3 acute kidney injury and were more likely to have had new left bundle branch block and high-degree atrioventricular block. Patients who underwent TAVI under CS had significantly higher in-hospital and 1-year mortality rates compared to LA (1.6% vs. 0.0%
CONCLUSIONS
CONCLUSIONS
As compared to CS, the LA-only approach is associated with lower rates of peri-procedural complications and 1-year mortality rates.
Identifiants
pubmed: 35683525
pii: jcm11113134
doi: 10.3390/jcm11113134
pmc: PMC9181727
pii:
doi:
Types de publication
Journal Article
Langues
eng
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