General Anesthesia or Conscious Sedation for Transfemoral Aortic Valve Replacement with the SAPIEN 3 Transcatheter Heart Valve
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- Neumann Franz-Josef
- University Heart Centre Freiburg/Bad Krozingen, University of Freiburg
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- Redwood Simon
- King's Health Partners
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- Abdel-Wahab Mohamed
- Leipzig Heart Center
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- Lefèvre Thierry
- Institut Cardiovasculaire Paris Sud, Hopital privé Jacques Cartier
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- Frank Derk
- University Hospital, Schleswig-Holstein, Kiel and DZHK (German Center for Cardiovascular Research, Kiel/Lübeck/Hamburg)
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- Eltchaninoff Hélène
- Department of Cardiology, Rouen University Hospital, FHU REMOD-VHF, F76000
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- Caussin Christophe
- Institut Mutualiste Montsouris
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- Stella Pieter R.
- University Medical Center
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- Hovorka Tomas
- Statistics Department, Edwards Lifesciences
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- Baumgartner Helmut
- Department of Cardiology III, University Hospital, Adult Congenital & Valvular Heart Disease
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- Tarantini Giuseppe
- Padova Hospital
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- Wendler Olaf
- King's College Hospital
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- Treede Hendrik
- University Heart Center
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抄録
<p>Differences in the benefits of conscious sedation (CS) and general anesthesia (GA) during transfemoral aortic valve implantation (TAVI) are unclear.</p><p>We aimed to assess differences in procedural and clinical outcomes based on the type of anesthesia received during TAVI.</p><p>We analyzed SOURCE 3 Registry data for patients who received the SAPIEN 3 valve by type of anesthesia used during TAVI.</p><p>Of the 1694 TAVI patients, 1027 received CS and 667 received GA. Patients were similar at baseline (81.5 years; Society of Thoracic Surgeons risk score 7.0). Compared with the GA group, the CS group had fewer intra-procedural transesophageal echocardiography (TEE) and post implantation dilatations performed, and less contrast medium was used. The CS group had significantly less kidney injury at 7 days post-procedure than the GA group (0.4% versus 1.5%, P = 0.014). Moderate paravalvular leaks (PVL) occurred more frequently in the CS group versus the GA group (2.2% versus 0.8%; P = 0.041). No severe PVL were reported. Median total hospital length of stay (LOS) after TAVI was 10 days in the CS group and 11 days in the GS group. At 30 days, all-cause death was 2.1% in CS and 1.7% in GS (P = 0.47), and myocardial infarction was 0.2% in CS and 0.1% in GS (P = 0.83).</p><p>Our analyses found no significant major outcome differences between CS and GA during TAVI.</p>
収録刊行物
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- International Heart Journal
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International Heart Journal 61 (4), 713-719, 2020-07-30
一般社団法人 インターナショナル・ハート・ジャーナル刊行会