Local versus general anaesthesia for transcatheter aortic valve implantation (TAVI): a systematic review, meta-analysis, and trial sequential analysis of randomised and propensity-score matched studies.
Jaffar-Karballai, Mona Al-Tawil, Mohammed Roy, Sakshi Kayali, Fatima Vankad, Maariyah Shazly, Ahmed Zeinah, Mohamed Harky, Amer
Jaffar-Karballai, Mona
Al-Tawil, Mohammed
Roy, Sakshi
Kayali, Fatima
Vankad, Maariyah
Shazly, Ahmed
Zeinah, Mohamed
Harky, Amer
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2023-12-19
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Abstract
Transcatheter aortic valve implantation (TAVI) is a common practice for severe aortic stenosis, but the choice between general (GA) and local anesthesia (LA) remains uncertain. We conducted a comprehensive literature review until April 2023, comparing the safety and efficacy of LA versus GA in TAVI procedures. Our findings indicate significant advantages of LA, including lower 30-day mortality rates (RR: 0.69; 95% CI [0.58, 0.82]; p < 0.001), shorter in-hospital stays (mean difference: -0.91 days; 95% CI [-1.63, -0.20]; p = 0.01), reduced bleeding/transfusion incidents (RR: 0.64; 95% CI [0.48, 0.85]; p < 0.01), and fewer respiratory complications (RR: 0.56; 95% CI [0.42, 0.76], p<0.01). Other operative outcomes were comparable. Our findings reinforce prior evidence, presenting a compelling case for LA's safety and efficacy. While patient preferences and clinical nuances must be considered, our study propels the discourse towards a more informed anaesthesia approach for TAVI procedures.
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Jaffar-Karballai M, Al-Tawil M, Roy S, Kayali F, Vankad M, Shazly A, Zeinah M, Harky A. Local versus General Anaesthesia for Transcatheter Aortic Valve Implantation (TAVI): A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomised and Propensity-Score Matched Studies. Curr Probl Cardiol. 2023 Dec 19;49(3):102360. doi: 10.1016/j.cpcardiol.2023.102360. Epub ahead of print. PMID: 38128636.
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