The ambitious SOLVE-TAVI (soon to be published in JACC) is aimed at answering to of the most important questions we make when facing a TAVR procedure: What valve do we choose, a self-expanding or a balloon expandable? And once we have chosen our device, do we proceed with general anesthesia or conscious sedation? The…
Conscious Versus General Anesthesia in TAVR
Patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) can safely undergo the procedure under conscious sedation. Conscious sedation has been adopted in clinical practice as a natural way of simplifying and conducting the procedure in the least invasive way possible. Currently, up to 50% of patients undergo TAVR under conscious sedation, but…
Minimalist TAVR to the Max
Transcatheter aortic valve replacement (TAVR) is increasingly being performed under conscious sedation, which is associated with a multi-point benefit (including mortality). This paper, recently published in JACC Intv., shows that general anesthesia is becoming obsolete, although the magnitude the benefit derived from conscious sedation appears to be lower than in previous studies. The aim of…
TCT 2018 | SOLVE-TAVI: Self-Expandable vs. Balloon-Expandable Valves and General vs. Local Anesthesia in One Study
This prospective, randomized, multicenter study included 447 patients with severe aortic stenosis and intermediate or high surgical risk randomized in a 2×2 factorial design to general vs. conscious sedation with local anesthesia and also to receiving the Sapien 3 valve (balloon-expandable) vs. CoreValve Evolut R (self-expandable). Primary end point was a composite of all-cause mortality,…
MitraClip Procedure Can Be Performed without General Anesthesia
Courtesy of Dr. Carlos Fava. Avoiding general anesthesia in intervention procedures has the benefits of faster recovery and shorter hospitalization. This has been already analyzed in the context of TAVR, but not in MitraClip procedures. The present study analyzed 232 patients receiving the MitraClip. 76 of these procedures were done under general anesthesia (32.7%) and…
Conscious Sedation in TAVR: Is It Advisable?
The fundamental advantage offered by transcatheter aortic valve replacement (TAVR) has always been the fact that it is less invasive than surgical valve replacement. So far, most improvements for these devices have derived in less invasiveness (e.g., by improving the profile of the eluting system). However, there are also cases of “deployment” reduction during the…
Additional Benefit from Radial Artery Graft in Myocardial Revascularization Surgery
Used to different extents according to institution, surgeon, and historical time, the radial artery graft is yet to prove whether it can improve the outcomes of myocardial revascularization surgery when added to a single or bilateral internal thoracic artery graft. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral vs. single left internal…
SOLACI CACI 2017 | Role of general anesthesia compare to conscious sedation during TAVR
Read articles on the main presentations of the first day of SOLACI-CACI 2017 Congress. Check the presentation of Dr. Andreas Baumbach, entitled “Role of general anesthesia compare to conscious sedation during TAVR”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.