Tavi Under Conscious Sedation
TAVI under conscious sedation, a beneficial alternative to general anaesthesia
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
Shorter procedure time
Shorter ICU and hospital stay
Comparable procedural success
Comparable low rates of adverse events
- Residual PVL
- Annular rupture
- MI
- Stroke
- Vascular complications
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;
References
Abbrevations: ICU: intensive care unit; MI: myocardial infarction; PVL: paravalvular leak; QoL: quality of life;
References
- Villablanca PA, et al. Catheter Cardiovasc Interv. 2017; 1–13.
- Ludman PF. Heart 2019; 105: s2–s5.
- Sato K, Jones PM. J Thorac Dis. 2018; 10(30): S3588–S3594.
- Academy of Medical Royal Colleges. Safe Sedation Practice for Healthcare Procedures, October 2013.
- Hyman MC, et al. Circulation 2017; 136(22): 2132–2140.
- Toppen W, et al. PLoS ONE 2017; 12(4): e0173777.
- Eskandari M, et al. Heart 2018; 0: 1–8.
- Fröhlich G, et al. BMC Medicine 2014; 12: 41–49.
- Maas EHA, et al. Curr Pharm Des. 2016; 22(13): 1868–1878.
- Mansoon A, et al. Cureus 2019; 11(6): e4812. 11. Ehret C, et al. BMJ Open 2017; 7: e016321.
About Us
We are an expert team providing proper comprehensive care for people undergoing structural heart and heart valve-related procedures.
Explore
© Heart Valve Experts. 2024. All rights reserved. Site Designed by U1R