Letter to the EditorTowards minimally invasiveness: Transcatheter aortic valve implantation under local analgesia exclusively
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Conflict of interest
There are no conflicts of interest.
References (10)
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Cited by (28)
Feasibility and safety of transfemoral transcatheter aortic valve implantation performed with a percutaneous coronary intervention-like approach
2021, Archives of Cardiovascular DiseasesCitation Excerpt :Although it was not the purpose of our study, the two approaches (PCI and regular) were observed to be very different regarding the type of local anaesthesia, as all the patients in the regular approach group received LACS versus only 29% of patients with PCI approach (and exclusively with midazolam). Notably, we observed a shorter duration of stay with the PCI approach, which could be an additional benefit of local anaesthesia, related to faster mobilization and less delirium, as suggested by other studies [6,20,21]. We observed that 75% of the TF-TAVI patients screened in this programme were eligible for the PCI approach.
General Anesthesia Versus Conscious Sedation for Transcatheter Aortic Valve Replacement—An Analysis of Current Outcome Data
2018, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Defining the terminology in the literature of anything besides GA for TAVR is challenging, but this has generally referred to any approach that avoids the use of general endotracheal anesthesia.15 Very few groups have published on the use of LA alone without any procedural sedation, but this technique is best accomplished with 10 to 40 mL of 1% to 2% lidocaine injected at the percutaneous access site.16,17 Much more commonly utilized is a combined approach using LA with profoundly varying degrees of CS ranging from very mild anxiolysis and pain relief to deeper sedation where the patient is unable communicate.
Conversion from Monitored Anesthesia Care to General Anesthesia for Transcatheter Aortic Valve Replacement
2018, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :A large retrospective study showed decreased hospital length of stay and decreased pulmonary complications as compared to patients who received GA.39 EVARs are similar to TAVR in that they involve femoral arterial punctures in supine patients. Average operating times for EVARs are longer than TAVRs,28,39 but they do not require rapid pacing for deployment. That being said, both procedures have similar scenarios by which the mode of anesthesia may need to be converted from MAC to GA.
Transcarotid Transcatheter Aortic Valve Replacement: General or Local Anesthesia
2016, JACC: Cardiovascular InterventionsCitation Excerpt :In the current study, we compared for the first time 2 anesthesia strategies for transcarotid TAVR. An MIS has previously been described for transfemoral TAVR with favorable results (13,14), but there are no data on this technique for transcarotid vascular access. We introduced the MIS technique on the basis of encouraging data from TAVR and carotid endarterectomy studies (15–17).
Outcome After General Anesthesia Versus Monitored Anesthesia Care in Transfemoral Transcatheter Aortic Valve Replacement
2016, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :The shift from general anesthesia towards MAC could be seen as a major step toward less-invasive TAVR. This may translate into a shorter procedural time as well as length of intensive care unit and hospital stay with significantly decreased costs and important implications for financial viability of the transcatheter approach.6,8,15–18 Some authors even have proposed local anesthesia as a more cost-effective means of performing TAVR with a "minimalist approach" under responsibility of an interventionalist, thus avoiding the routine presence of anesthesiologists and reducing labor costs.7,26,30,31
Monitored Anesthesia Care Versus General Anesthesia: Experience With the Medtronic CoreValve
2016, Journal of Cardiothoracic and Vascular Anesthesia