Short Term Outcomes of Patients Undergoing TAVI with and without the Presence of an Anesthesiologist in the Catheterization Laboratory

Background: Despite the rapidly growing number of Transcatheter Aortic Valve Implantation (TAVI) procedures, there is no consensus regarding the anesthetic management of these patients. During the last few years a shift is observed from performing TAVI under general anesthesia towards conscious sedation and local anesthesia only, with the presence of anesthesiologist in the catheterization laboratory. In our center a large portion of TAVI procedures are performed without the presence of an anesthesiologist. Here we compare short term outcome of patients undergoing TAVI with and without the presence of anesthesiologist in the catheterization laboratory.

Methods and results: from October 2014 through November 2015, 214 patients (mean age 83.3±5) with severe aortic stenosis were prospectively assigned to transfemoral TAVI with (136 patients) or without (78 patients) an anesthesiologist. Baseline clinical and echocardiographic characteristics were similar between the groups. 30 days mortality did not differ between the groups (2.9% vs. 1.3%, with and without anesthesiologist, respectively, p=0.39) vascular complications as well as major/life threatening bleeding also did not differ among the 2 groups (10.3% and 7.8% vs. 18.5% and 8.1%, P= 0.1 and 0.93 respectively). The rates of acute kidney injury, pacemaker implantations and infections were also similar among the groups (p= 0.56, 0.67 and 0.79 respectively)

Conclusions the presence of an anesthesiologist in the catheterization laboratory during transfemoral TAVI did not change short term outcome of patients undergoing this procedure.