General versus Local Anesthesia with Intravenous Sedation in Transcatheter Aortic Valve Implantation

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Surgery Pub Date : 2023-10-26 DOI:10.1155/2023/1379034

Alexander Schutz, Zvonimir Krajcer, Qianzi Zhang, Scott A. LeMaire, Katherine G. Dougherty, Juan Carlos Plana, Stephanie A. Coulter, Neil E. Strickman, Guilherme V. Silva, James Anton, Joseph S. Coselli, Ourania Preventza

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引用次数: 0

Abstract

Background. Monitored anesthesia care (MAC) may offer better outcomes than general anesthesia (GA) in transcatheter aortic valve implantation (TAVI). We compared TAVI outcomes between patients who received MAC versus GA. Methods. We retrospectively reviewed data from all patients (N = 659), as well as 216 propensity-matched patients, who underwent TAVI at our institution during 2014–2019. Results. MAC and GA did not differ significantly in mortality (1.6% MAC vs. 4.2% GA,

p

= 0.05) or stroke (2.2% MAC vs. 2.4% GA,

p

= 0.96); however, median length of stay (LOS) was shorter in the MAC group (2 d MAC vs. 7 d GA,

p

< 0.0001). In propensity-matched patients, mortality (2.8% MAC vs. 4.6% GA,

p

= 0.7) and stroke (3.7% MAC vs. 1.9% GA,

p

= 0.7) did not differ significantly between groups. LOS remained shorter in the MAC group (2 d MAC vs. 7 d GA,

p

< 0.0001). Conclusions. In this large, single-center, retrospective study, MAC was associated with shorter hospital stay after TAVI.

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经导管主动脉瓣置入术中静脉镇静全麻与局麻对比

背景。在经导管主动脉瓣植入术(TAVI)中，麻醉监护(MAC)可能比全身麻醉(GA)提供更好的结果。我们比较了接受MAC和GA治疗的患者的TAVI结果。方法。我们回顾性回顾了2014-2019年期间在我们机构接受TAVI治疗的所有患者(N = 659)以及216名倾向匹配的患者的数据。结果。MAC组和GA组在死亡率(1.6% MAC vs. 4.2% GA, p = 0.05)或卒中(2.2% MAC vs. 2.4% GA, p = 0.96)方面无显著差异;然而，MAC组的中位住院时间(LOS)更短(MAC 2 d vs. GA 7 d, p <0.0001)。在倾向匹配的患者中，死亡率(2.8% MAC vs. 4.6% GA, p = 0.7)和卒中(3.7% MAC vs. 1.9% GA, p = 0.7)组间无显著差异。MAC组的LOS仍较短(MAC 2 d vs. GA 7 d, p <0.0001)。结论。在这项大型、单中心、回顾性研究中，MAC与TAVI术后住院时间缩短有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiac Surgery 医学-外科

CiteScore

2.90

自引率

12.50%

发文量

976

审稿时长

3-8 weeks

期刊介绍： Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.