Comparison of Outcomes of Transfemoral Transcatheter Aortic Valve Implantation Using a Minimally Invasive Versus Conventional Strategy

Attizzani, Guilherme F.; Alkhalil, Ahmad; Padaliya, Bimal; Tam, Chi‐Yung; Lopes, Jorge O.; Fares, Anas; Bezerra, Hiram G.; Medallion, Benjamin; Park, Soon; Deo, Salil V.; Sareyyüpoğlu, Başar; Parikh, Sahil A.; Zidar, David A.; Elgudin, Yakov; Popovich, Kehllee; Davis, Angela; Staunton, Elizabeth; Tomić, Ana; Mazzurco, Stacey; Avery, Edward E.; Markowitz, Alan H.; Simon, Daniel I.; Costa, Marco A.

doi:10.1016/j.amjcard.2015.08.044

Cited by 47 publications

(40 citation statements)

References 24 publications

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“…In the sensitivity analyses, with each study removed individually, the only significant outcome that changed in the summary risk ratio estimates was fluoroscopy time. When 3 of the included studies were removed from the analysis, the overall effect estimate became nonsignificant for fluoroscopy time ( P > 0.05) (Supporting Information, Figure 3A‐Q). On analyzing studies with only transfemoral access, the overall mortality remains significantly lower in the LA group [RR 0.67 (95% CI 0.47–0.96)].…”

Section: Resultsmentioning

confidence: 99%

Comparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta‐analysis

Villablanca

Mohananey

Nikolić

et al. 2017

Cathet Cardio Intervent

105

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Section: Resultsmentioning

confidence: 99%

Comparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta‐analysis

Villablanca

Mohananey

Nikolić

et al. 2017

Cathet Cardio Intervent

105

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“…Recent data from the Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry show the median overall LOS for TAVR procedures at 6 days (5 days for transfemoral access and 8 days for non‐transfemoral access routes). The tendency of shorter post‐procedural LOS at our center is explained by several factors: A growing TAVR interventional experience, a minimalist approach that eliminates the need for general anesthesia and hastens recovery, and multi‐disciplinary team approach with special emphasis on pre‐procedural planning which helps individualize care and anticipate possible obstacles to early discharge . Interestingly, discharge disposition to home was associated with sLOS.…”

Section: Discussionmentioning

confidence: 96%

Safety of shorter length of hospital stay for patients undergoing minimalist transcatheter aortic valve replacement

Alkhalil

Lamba

Deo

et al. 2017

Cathet Cardio Intervent

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“…We reviewed 35 full-text articles and identified 20 articles for inclusion in our review (figure 1). [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] All the studies were observational studies except one RCT. 32 Table 1 shows the baseline clinical characteristics of the included studies.…”

Section: Study Selection and Eligibility Criteriamentioning

confidence: 99%

Is local anaesthesia a favourable approach for transcatheter aortic valve implantation? A systematic review and meta-analysis comparing local and general anaesthesia

et al. 2017

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ObjectivesWe conducted a systematic review and meta-analysis to identify the potential favourable effects of local anaesthesia plus sedation (LAS) compared with general anaesthesia (GA) in transcatheter aortic valve implantation (TAVI).MethodsElectronic databases (PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials) and the reference lists of eligible publications were screened for randomised controlled trials (RCTs) and observational studies published between 1 January 2006 and 26 June 2016 that compare LAS to GA in an adult study population undergoing TAVI. We conducted study quality assessments using the Cochrane risk of bias tool and structured the review according to PRISMA. A meta-analysis calculating the pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) under the assumption of a random-effects model was performed. Statistical heterogeneity was evaluated using the I² statistic and Cochran’s Q-test.ResultsAfter database screening, one RCT and 19 observational studies were included in the review. We found no differences between LAS and GA in terms of 30-day mortality, in-hospital mortality and other endpoints that addressed safety and complication rates. LAS was associated with a shorter ICU and hospital stay and with lower rates of catecholamine administration and red blood cell transfusion. New pacemaker implantations occurred more frequently under LAS. The overall conversion rate from LAS to GA was 6.2%.ConclusionFor TAVI, both LAS and GA are feasible and safe. LAS may have some benefits such as increased haemodynamic stability and shorter hospital and ICU stays, but it does not impact 30-day mortality. Since there is a paucity of randomised trial data and the findings are mainly based on observational study data, this review should be considered as a hypothesis-generating article for subsequent RCTs that are required to confirm the potential favourable effects we detected for LAS.Registration numberCRD42016048398 (PROSPERO).

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Comparison of Outcomes of Transfemoral Transcatheter Aortic Valve Implantation Using a Minimally Invasive Versus Conventional Strategy

Cited by 47 publications

References 24 publications

Comparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta‐analysis

Comparison of local versus general anesthesia in patients undergoing transcatheter aortic valve replacement: A meta‐analysis

Safety of shorter length of hospital stay for patients undergoing minimalist transcatheter aortic valve replacement

Is local anaesthesia a favourable approach for transcatheter aortic valve implantation? A systematic review and meta-analysis comparing local and general anaesthesia

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