Sedation versus general anesthesia on all-cause mortality in patients undergoing percutaneous procedures: a systematic review and meta-analysis

BMC Anesthesiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: April 2, 2024

Abstract Background The comparison between sedation and general anesthesia (GA) in terms of all-cause mortality remains a subject ongoing debate. primary objective our study was to investigate the impact GA on order provide clarity this controversial topic. Methods A systematic review meta-analysis were conducted, incorporating cohort studies RCTs about postoperative mortality. Comprehensive searches performed PubMed, EMBASE, Cochrane Library databases, with search period extending until February 28, 2023. Two independent reviewers extracted relevant information, including number deaths, survivals, risk effect values at various time points following surgery, these data subsequently pooled analyzed using random effects model. Results total 58 included analysis, majority focusing endovascular surgery. findings analysis indicated that, overall, most subgroup analyses, exhibited superiority over in-hospital 30-day However, no significant difference observed analyses specific cerebrovascular About 90-day mortality, centered around Although overall results showed GA, distinction ORs based matched studies. For one-year all focused cardiac macrovascular No found HRs derived from Conclusions suggested potential particularly context mitigating death. for longer periods, uncertain. Trial registration PROSPERO CRD42023399151; registered 24

Language: Английский

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Implante percutáneo de válvula aórtica. Nuevos retos para los profesionales de la enfermería

Publicación Científica de la Asociación Española en Enfermería en Cardiología, Journal Year: 2025, Volume and Issue: XXXI(92), P. 41 - 49

Published: May 7, 2025

La estenosis aórtica constituye actualmente la enfermedad valvular más prevalente en países desarrollados y se prevé una tendencia ascenso significativo debido al envejecimiento de población, principal etiología. En 2021, circunscribe esta patología con prevalencia que aproxima 13% los pacientes edades superiores a 85 años. El implante percutáneo válvula es el tratamiento elección mejora supervivencia no candidatos cirugía cardíaca convencional. Enfermería de­sempeña un rol clave proceso cuidado integral del paciente, desde valoración preoperatoria hasta seguimiento posoperatorio, cuidados esenciales para recuperación óptima holística. Se describe caso aórtico mujer 65 años miocardiopatía dilatada isquémica severa. analizaron las necesidades paciente según modelo Virginia Henderson, posteriormente determinaron diagnósticos enfermería Asociación Norteamericana Diagnósticos (NANDA), clasificación resultados e intervenciones enfermería. identificaron varios especial interés, tanto reales como riesgo. Destacar plan manejo ansiedad relacionadas escucha apoyo. considera necesaria implantación figura holística coordinadora gestión familia equipos multidisciplinares, Tavi Nurse, fin alcanzar calidad seguridad todo pre, intra posquirúrgico. Su educación personalización cuidados, lo promueve rápida segura. Palabras clave: Atención enfermería, Cuidados perioperatorios, Estenosis aórtica, Reemplazo transcatéter, TAVI nurse. Aortic stenosis is currently the most prevalent valve disease in developed countries and significant upward trend expected due to aging of population, its main etiology. In this pathology had prevalence approximately patients over years age. Percutaneous aortic implantation treatment choice that improves survival who are not candidates for conventional cardiac surgery. Nursing plays key role patient‘s care process, from preoperative assessment postoperative follow-up, essential an optimal holistic recovery. We case percutaneous 65-year-old woman with ischemic dilated cardiomyopathy severe stenosis. The needs were analyzed according Henderson model, then nursing diagnoses North American Diagnosis Association Classification Outcomes Interventions determined. Several special interest, both real at-risk, identified. Highlighted related anxiety management interventions listening support. implementation coordinating figure patient, family, multidisciplinary teams, considered necessary achieve quality patient safety throughout pre-, intra-, post-surgical process. Their education personalization plan, which promotes faster safer Keywords: Care, Pre-operative care, Valve Stenosis, Transcatheter Replacement,

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The association between different anesthetic techniques and outcomes in patients undergoing transfemoral aortic valve replacement

Saudi Journal of Anaesthesia, Journal Year: 2024, Volume and Issue: 18(2), P. 197 - 204

Published: March 14, 2024

Background: There is an increasing number of patients undergoing transfemoral aortic valve replacement (TAVR) with sedation. limited data assessing the efficacy and safety different types sedative drugs. The objective was to compare two sedation techniques regard need for vasoactive support, respiratory rate conversion general anesthesia (GA), common perioperative morbidities, intensive care unit (ICU) stay, in-hospital mortality. Methods: A retrospective chart review study conducted among who underwent TAVR at a specialized cardiac center between January 2016 December 2019. Data collection included patient diagnosis, preoperative comorbidities, intraoperative outcomes, postoperative outcomes. Results: total 289 received local anesthesia; 210 propofol infusion 79 mixed propofol-ketamine (Ketofol). average age 75.5 ± 8.9 years 58.1% were females. Comparing ketofol groups, 31.2% 34.2% required drug 7.6% 6.3% GA, 46.7% 59.5% respectively. These outcomes not significantly P = 0.540, 0.707, 0.105, In-hospital 30-day mortality in groups 1.9% 3.8%, respectively, 0.396. In both median post-procedure coronary stay 26 hours while hospital 3 days. Conclusions: no significant differences or receiving either ketofol. Propofol infusion, alone ketamine, reliable safe, minimal side effects.

Language: Английский

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Use of single large-bore access for transcatheter aortic valve replacement (TAVR) in complex clinical scenarios: A case series

Cardiovascular Revascularization Medicine Interesting Cases, Journal Year: 2024, Volume and Issue: 2, P. 100026 - 100026

Published: May 3, 2024

Sometimes secondary vascular access during transfemoral transcatheter aortic valve replacement (TAVR) may be challenging due to hostile anatomy, representing a further source of complications. In such cases, minimalist approach with single femoral ("all-in-one" technique) performed. Here we describe how successfully perform the "all-in-one" technique, reporting 3 cases TAVR for which single-access was used overcome challenges in obtaining arterial and minimize sources complications, according patients' characteristics procedural aspects.

Language: Английский

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Updates in Structural Cardiovascular Interventions: Key Insights from Recent Studies

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(20), P. 6115 - 6115

Published: Oct. 14, 2024

The year 2024 brought remarkable advancements and high-quality evidence to the field of cardiovascular interventions [...].

Language: Английский

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Whether monitored anesthesia care is the optimal anesthetic strategy for transcatheter aortic valve implantation surgery? a meta-analysis and systematic review

BMC Anesthesiology, Journal Year: 2024, Volume and Issue: 24(1)

Published: Nov. 27, 2024

To explore whether monitored anesthesia care is more beneficial to the outcome of transcatheter aortic valve implantation. The research methodology involved comprehensive searches across major databases, including Cochrane Library, PubMed, Scopus, and Web Science, covering period from January 1, 2010, March 2024. aim was identify trials comparing different anesthetic methods for primary outcomes assessed were mortality length hospital stay, while secondary included common complications such as bleeding, stroke, paravalvular leakage, renal failure, others. Data synthesis conducted using risk ratios or standardized mean differences, along with 95% confidence intervals. study protocol prospectively registered PROSPERO (CRD42024507749). A total 35 45,616 patients in this study. results showed that significantly reduced patient's death, shortened also leakage (RR, 0.80; CI: 0.72 0.88; p < 0.00001; I2 = 0) stroke 0.65 0.99; 0.04; 0). Monitored has an absolute advantage patient survival effectively shortens hospitalization. In addition, it reduces stroke. Monitoring under plays a vital role during TAVI surgery, not only helping ensure smooth progress surgery safety, but promoting recovery recovery.

Language: Английский

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Is Transcatheter Aortic Valve Replacement the New Percutaneous Coronary Intervention? Insights from the Japanese Experience

The American Journal of Cardiology, Journal Year: 2023, Volume and Issue: 210, P. 290 - 292

Published: Oct. 20, 2023

Language: Английский

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Awakening the Future: Exploring Awake or Minimalistic Transcatheter Aortic Valve Replacement and the Evolving Role of Sedation Strategies

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2023, Volume and Issue: 37(10), P. 1901 - 1903

Published: June 7, 2023

Language: Английский

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The 10 Commandments for Transaxillary TAVI

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery, Journal Year: 2023, Volume and Issue: 18(3), P. 212 - 216

Published: May 1, 2023

Language: Английский

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Patient Well-being and Satisfaction after General or Local Anesthesia with Conscious Sedation: A Secondary Analysis of the SOLVE-TAVI Trial

Anesthesiology, Journal Year: 2023, Volume and Issue: 139(5), P. 701 - 704

Published: Oct. 6, 2023

Research Letter| November 2023 Patient Well-being and Satisfaction after General or Local Anesthesia with Conscious Sedation: A Secondary Analysis of the SOLVE-TAVI Trial Matthias Heringlake, M.D.; M.D. 1Heart Diabetes Center Mecklenburg–Western Pomerania, Karlsburg Hospital, Karlsburg, Germany (M.H.). [email protected] [email protected] https://orcid.org/0000-0001-6949-7113 Search for other works by this author on: This Site PubMed Google Scholar Astrid Ellen Berggreen, Ursula Vigelius-Rauch, Sascha Treskatsch, Jörg Ender, Holger Thiele, Author Article Information (Accepted publication July 25, 2023.) Anesthesiology 2023, Vol. 139, 701–704. https://doi.org/10.1097/ALN.0000000000004715 Views Icon contents Figures & tables Video Audio Supplementary Data Peer Review Share Facebook Twitter LinkedIn Email Cite Get Permissions Citation Thiele; Trial. 2023; 139:701–704 doi: Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Dropdown Menu input auto suggest filter your All ContentAll PublicationsAnesthesiology Advanced Topics: anesthesia, local, conscious sedation, personal satisfaction, secondary data analysis, transcatheter aortic-valve implantation Transfemoral aortic valve replacement has become standard care older patients symptomatic stenosis.1 While most procedures were initially performed under general based on assumption that avoiding anesthesia may improve postinterventional well-being patient an increasing number are now local plus sedation.2 Since assumption, to best our knowledge, never been formally proven, primary hypothesis analysis was satisfaction would be higher in treated sedation comparison anesthesia. Recently, we have shown a 2 × factorial design, randomized, multicenter trial 447 medium- high-risk stenosis undergoing second-generation self-expandable balloon-expandable valves as well resulted similar... You do not currently access content.

Language: Английский

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