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• W2894484678 abstract "A ‘minimalist’ approach to transcatheter aortic valve replacement (TAVR) usually advocates avoidance of general anaesthesia; however, there is currently no consensus on the optimal degree of procedural sedation. We assessed the impact of the level of anaesthesia on procedural variables and early discharge using the Vancouver Clinical Pathway in the 3M (Multidisciplinary, Multimodality but Minimalist) TAVR Study. All patients that underwent TAVR without the use of general anaesthesia, across 13 sites in the 3M TAVR study, were included in the study cohort. Patients were assessed in two groups: local anaesthesia only versus procedural sedation. Outcomes were adjusted for baseline characteristics and site variation. A total of 375 patients underwent a minimalist approach with 123 (32.8%) patients undergoing TAVR with local anaesthesia only and 252 (67.2%) patients with procedural sedation. There was no significant difference in procedural variables between local anaesthesia only and procedural sedation, with similar median contrast volume (123mls vs 114mls, p=0.99), fluoroscopy time (17mins vs 12.5min, p=0.34) and median procedural time (50mins vs 44mins, p=0.99) respectively, during TAVR. Mean aortic gradients after TAVR deployment were also similar between groups (10mmHg vs 7mmHg, p=0.10). There was no significant difference between local versus procedural sedation for discharge within 48hours (84.6% vs 92.3%, p=0.66), readmissions (10.8% vs 8.7%, p=0.43), or a composite of all-cause mortality and stroke at 30-days (2.5% vs 2.0%, p=0.77). There was considerable heterogeneity in the degree of procedural sedation in the 3M TAVR Study; however, the level of anaesthesia did not impact procedural variables, length of stay, or cardiac readmission rates. Local anesthesia only or minimal procedural sedation are likely reasonable anesthetic strategies when utilizing the Vancouver Clinical Pathway for TAVR." @default.
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• W2894484678 date "2018-10-01" @default.
• W2894484678 modified "2023-10-17" @default.
• W2894484678 title "IMPACT OF LEVEL OF ANAESTHESIA USING THE VANCOUVER CLINICAL PATHWAY FOR TRANSCATHETER AORTIC VALVE REPLACEMENT: INSIGHTS FROM THE 3M TAVR STUDY" @default.
• W2894484678 doi "https://doi.org/10.1016/j.cjca.2018.07.217" @default.
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