Local versus General Anaesthesia for Transcatheter Aortic Valve Implantation (TAVI): A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomised and Propensity-Score Matched Studies.
Curr Probl Cardiol
; 49(3): 102360, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-38128636
ABSTRACT
Transcatheter aortic valve implantation (TAVI) is a common practice for severe aortic stenosis, but the choice between general (GA) and local anesthesia (LA) remains uncertain. We conducted a comprehensive literature review until April 2023, comparing the safety and efficacy of LA versus GA in TAVI procedures. Our findings indicate significant advantages of LA, including lower 30-day mortality rates (RR 0.69; 95% CI [0.58, 0.82]; p < 0.001), shorter in-hospital stays (mean difference -0.91 days; 95% CI [-1.63, -0.20]; p = 0.01), reduced bleeding/transfusion incidents (RR 0.64; 95% CI [0.48, 0.85]; p < 0.01), and fewer respiratory complications (RR 0.56; 95% CI [0.42, 0.76], p<0.01). Other operative outcomes were comparable. Our findings reinforce prior evidence, presenting a compelling case for LA's safety and efficacy. While patient preferences and clinical nuances must be considered, our study propels the discourse towards a more informed anaesthesia approach for TAVI procedures.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
6_cardiovascular_diseases
Assunto principal:
Estenose da Valva Aórtica
/
Ensaios Clínicos Controlados Aleatórios como Assunto
/
Pontuação de Propensão
/
Substituição da Valva Aórtica Transcateter
/
Anestesia Geral
/
Anestesia Local
Tipo de estudo:
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Curr Probl Cardiol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Reino Unido