Local against general anesthesia for transcatheter aortic valve replacement

Authors : Serhat GÜNLÜ, Fethullah KAYAN, Tuncay GÜZEL, Adem AKTAN, Muhammed Raşit TANIRCAN, Mehmet Zülkif KARAHAN

Pages : 68-75

Doi:10.58961/hmj.1317761

View : 43 | Download : 60

Publication Date : 2023-08-21

Article Type : Research Paper

Abstract :Background/Aims: Transcatheter aortic valve replacement insert ignore into journalissuearticles values(TAVR); poses significant challenges concerning anesthesia management. There is no consensus on the type of safer anesthesia for TAVR procedures. We aimed to evaluate the effectiveness and safety of TAVR performed with trans-femoral approach under local anesthesia with sedation insert ignore into journalissuearticles values(LAS); against general anesthesia insert ignore into journalissuearticles values(GA);. Methods: This observational and retrospective analysis included individuals who were admitted on a planned basis from 2016 to 2022 and underwent Transfemoral TAVR. Effectiveness and safety outcomes were evaluated at 30 days. İndividuals were separated into two groups: GA and LAS. Demographic characteristics and procedural data were recorded during hospitalization. Results: 115 patients were included, of whom 62 insert ignore into journalissuearticles values(53.9%); received LAS and 53 received GA insert ignore into journalissuearticles values(46.1%);. 59 female insert ignore into journalissuearticles values(48.8%); patients with a mean age of 83.2±5.7 participated in the study. Successful TAVR procedure was performed in 100 insert ignore into journalissuearticles values(86.9%); of 115 patients with the transfemoral approach. The mean procedure time was 136.7±46.7 minutes, and the procedure time was shorter in patients who underwent LAS against GA insert ignore into journalissuearticles values(p=0.001);. There were no differences among the groups including fluoroscopy time, contrast, and radiation dose insert ignore into journalissuearticles values(p>0.05);. In 2 patients insert ignore into journalissuearticles values(3.2%);, significant vascular complications necessitated immediate surgical intervention, necessitating a change in the anesthesia technique. Overall 30-day mortality was 5.2%, with no significant differences among the groups insert ignore into journalissuearticles values(GA 7.5% vs. LAS 3.2%, p =0.28);. GA had substantially longer ICU and total hospitalization stays than LAS insert ignore into journalissuearticles values(p=0.009 and p =0.004, respectively);. Conclusions: In our study, TAVR via the transfemoral route using LAS was an alternative for GA.
Keywords : Lokal anestezi, aort stenozu, transfemoral TAVR