The effect of anesthesia management on mortality and morbidity in patients who underwent transcatheter aortic valve implantation

Abstract

Objectives: We aimed at investigating the effects of two different anesthesia techniques in our patients who underwent transcatheter aortic valve implantation (TAVI). Material and methods: The effects of two different anesthetic methods were retrospectively evaluated in 100 patients who underwent TAVI between January 2010 and October 2020. Patients were divided into a general anesthesia (GA) group and a sedation-local anesthesia (S-LA) group according to the anesthetic methods used. Results: Of 100 patients who underwent transcatheter aortic valve implantation, 20 (20%) received GA, and 80 (80%) received S-LA. The mean ages of the patient groups undergoing GA and S-LA were 76.20±7.22 and 75±8.44 years, respectively. The duration of the procedure and anesthesia was significantly longer in the GA patient group than in the S-LA patient group. With the exception of the logistic European Society of Cardiac Operative Risk Assessment, the demographic and preoperative data of the two groups were similar. The most common comorbidity in both groups was hypertension. When comparing complications between groups, the incidence of intraoperative hemodynamic instability, ephedrine use, inotropic drug use, intra-aortic balloon pump placement, postoperative infection and cardiac tamponade was significantly higher in the GA group. The length of intensive care and hospital stay was similar between the groups, but the 30-day and 3-month mortality rates were significantly higher in the GA group than in the S-LA group. Conclusion: S-LA provided more stable hemodynamics, shorter operative and anesthetic times, fewer intraoperative and postoperative complications, and reduced mortality. S-LA application during the TAVI procedure is a more reliable alternative to GA.

Keywords

• general anesthesia
• sedation
• aortic valve stenosis
• transcatheter aortic valve implantation