Anesthetic management for transcatheter aortic valve replacement: A national anesthesia clinical outcomes registry analysis.
Ann Card Anaesth
; 26(1): 29-35, 2023.
Article
em En
| MEDLINE
| ID: mdl-36722585
ABSTRACT
Background:
General anesthesia has traditionally been used in transcatheter aortic valve replacement; however, there has been increasing interest and momentum in alternative anesthetic techniques.Aims:
To perform a descriptive study of anesthetic management options in transcatheter aortic valve replacements in the United States, comparing trends in use of monitored anesthesia care versus general anesthesia. Settings andDesign:
Data evaluated from the American Society of Anesthesiologists' (ASA) Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry. Materials andMethods:
Multivariable logistic regression was used to identify predictors associated with use of monitored anesthesia care compared to general anesthesia.Results:
The use of monitored anesthesia care has increased from 1.8% of cases in 2013 to 25.2% in 2017 (p = 0.0001). Patients were more likely ages 80+ (66% vs. 61%; p = 0.0001), male (54% vs. 52%; p = 0.0001), ASA physical status > III (86% vs. 80%; p = 0.0001), cared for in the Northeast (38% vs. 22%; p = 0.0001), and residents in zip codes with higher median income ($63,382 vs. $55,311; p = 0.0001). Multivariable analysis revealed each one-year increase in age, every 50 procedures performed annually at a practice, and being male were associated with 3% (p = 0.0001), 33% (p = 0.012), and 16% (p = 0.026) increased odds of monitored anesthesia care, respectively. Centers in the Northeast were more likely to use monitored anesthesia care (all p < 0.005). Patients who underwent approaches other than percutaneous femoral arterial were less likely to receive monitored anesthesia care (adjusted odds ratios all < 0.51; all p = 0.0001).Conclusion:
Anesthetic type for transcatheter aortic valve replacements in the United States varies with age, sex, geography, volume of cases performed at a center, and procedural approach.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Substituição da Valva Aórtica Transcateter
/
Anestesiologia
/
Anestésicos
Tipo de estudo:
Prognostic_studies
Limite:
Aged80
/
Female
/
Humans
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Male
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article