The Impact of Anesthesia Type on Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

Abstract Objectives To assess postoperative outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) either under general anesthesia (GA) or monitored anesthesia care (MAC) as the primary anesthetic. Design A retrospective propensity-matched cohort study with univariable logistic regression to assess postoperative outcomes. Setting Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Participants The study comprised 559 patients who underwent TAVR under GA or MAC that was reported in the ACS NSQIP. Interventions None. Measurements and Main Results After propensity matching, there were no significant differences between the two cohorts in age, sex, race, BMI, functional status, American Society of Anesthesiologists (ASA) class and other comorbidities. There was no significant difference between the two cohorts in 30-day mortality or in the number of complications at 30 days, but hospital length of stay was significantly shorter in the MAC cohort compared to the GA cohort. Conclusions Patients undergoing TAVR under MAC may have similar 30-day mortality and numbers of complications at 30 days but shorter hospital length of stay than patients undergoing TAVR under GA.