Heart Murmur Heart Valve Disease
Conscious sedation has been increasingly used in TAVI procedures over time
With deeper sedation, the risks of adverse events and depression of the physiological systems rise. As an alternative to general anaesthesia, conscious sedation has numerous benefits for patients
| Minimal sedation | Conscious sedation | Deep sedation | General anaesthesia | |
|---|---|---|---|---|
| Responsiveness | Normal response to verbal stimulation | Purposeful* response to verbal or tactile stimulation | Purposeful*response to repeated or painful stimulation | Unarousable even with painful stimulus |
| Airway | Unaffected | No intervention required | Intervention may be required | Intervention may be required |
| Spontaneous ventilation | Unaffected | Adequate | May be inadequate | Frequently in adequate |
| Cardiovascular function | Unaffected | Usually maintained | Usually maintained | May be impaired |
Patients who undergo TAVI with conscious sedation may see improved outcomes
compared to those who undergo TAVI with general anaesthesia
| Outcome | Conscious sedation | General anaesthesia |
|---|---|---|
| 30-day mortality1 (p=0.01) |
4.5% (135/2,943) |
6.2% (123/1,961) |
| QoL score at 30-day follow-up (p<0.001) |
90 | 79 |
TAVI under conscious sedation leads to shorter procedure time and shorter hospital stay compared to TAVI under general anaesthesia
Comparable low rates of adverse events
Quality of life scores assessed using the Kansas City Cardiomyopathy 12-question survey. *Data based on observational studies,
Abbrevations: ICU: intensive care unit; MI: myocardial infarction; PVL: paravalvular leak; QoL: quality of life;
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