Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention
Patients with severe calcific native aortic valve stenosis (AS) who require valve replacement have two options, surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). TAVR was approved in late 2011 for extremely high-risk patients and was subsequently approved for...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2024/4217162 |
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| author | Kahtan Fadah Seyed Khalafi Miller Corey Jose Sotelo Ahmed Farag Tariq Siddiqui Mehran Abolbashari |
| author_facet | Kahtan Fadah Seyed Khalafi Miller Corey Jose Sotelo Ahmed Farag Tariq Siddiqui Mehran Abolbashari |
| author_sort | Kahtan Fadah |
| collection | DOAJ |
| description | Patients with severe calcific native aortic valve stenosis (AS) who require valve replacement have two options, surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). TAVR was approved in late 2011 for extremely high-risk patients and was subsequently approved for high-risk (2012), intermediate-risk (2016), and low-risk (2019) patients. In 2019, TAVR procedures surpassed SAVR procedures for the first time in the United States. The approach to anesthesia for this procedure has also evolved. Initially, general anesthesia (GA) was preferred, but currently, conscious sedation (CS) is favored. This review aims to clarify the indications and contraindications for both approaches, as well as the advantages of one approach over the other. Recent studies show that conscious sedation has better outcomes in terms of all-cause mortality, procedure complications such as stroke, myocardial infarction, infection requiring antibiotics, acute kidney injury, and the need for inotropes or vasopressors. |
| format | Article |
| id | doaj-art-7ebcb58ddaf5423d8b652aacd40d1890 |
| institution | Kabale University |
| issn | 2090-0597 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-7ebcb58ddaf5423d8b652aacd40d18902025-02-03T07:23:41ZengWileyCardiology Research and Practice2090-05972024-01-01202410.1155/2024/4217162Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal InterventionKahtan Fadah0Seyed Khalafi1Miller Corey2Jose Sotelo3Ahmed Farag4Tariq Siddiqui5Mehran Abolbashari6Division of CardiologyPaul L. Foster School of MedicinePaul L. Foster School of MedicineDepartment of Internal MedicineDepartment of Internal MedicineTash Medical ClinicCenter of the HeartPatients with severe calcific native aortic valve stenosis (AS) who require valve replacement have two options, surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). TAVR was approved in late 2011 for extremely high-risk patients and was subsequently approved for high-risk (2012), intermediate-risk (2016), and low-risk (2019) patients. In 2019, TAVR procedures surpassed SAVR procedures for the first time in the United States. The approach to anesthesia for this procedure has also evolved. Initially, general anesthesia (GA) was preferred, but currently, conscious sedation (CS) is favored. This review aims to clarify the indications and contraindications for both approaches, as well as the advantages of one approach over the other. Recent studies show that conscious sedation has better outcomes in terms of all-cause mortality, procedure complications such as stroke, myocardial infarction, infection requiring antibiotics, acute kidney injury, and the need for inotropes or vasopressors.http://dx.doi.org/10.1155/2024/4217162 |
| spellingShingle | Kahtan Fadah Seyed Khalafi Miller Corey Jose Sotelo Ahmed Farag Tariq Siddiqui Mehran Abolbashari Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention Cardiology Research and Practice |
| title | Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention |
| title_full | Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention |
| title_fullStr | Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention |
| title_full_unstemmed | Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention |
| title_short | Optimizing Anesthetic Selection in Transcatheter Aortic Valve Replacement: Striking a Delicate Balance between Efficacy and Minimal Intervention |
| title_sort | optimizing anesthetic selection in transcatheter aortic valve replacement striking a delicate balance between efficacy and minimal intervention |
| url | http://dx.doi.org/10.1155/2024/4217162 |
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