Monitored Anesthesia Care Versus General Anesthesia: Experience With the Medtronic CoreValve

Abstract

Objective: To compare monitored anesthesia care (MAC) and general anesthesia (GA) for transcatheter aortic valve implantation (TAVI).

Design: Retrospective, case-control study.

Setting: A large university-affiliated hospital system.

Participants: The study comprised patients who underwent TAVI with the Medtronic CoreValve (Medtronic, Minneapolis, MN) between 2011 and 2015.

Interventions: None.

Measurements and main results: MAC (n = 44) and GA (n = 21) were compared in 65 patients who underwent TAVI. Baseline characteristics/demographics, hospital stay, intraoperative conditions, and intensive care unit (ICU)/hospital stays were compared using the chi-square test, unpaired t-test, or binomial regression where appropriate. There were no significant differences between patient populations with regard to 30-day mortality, ICU/hospital stay, and complication rates. The GA group used more blood product. The rate of ICU readmission was greater in the GA group but did not reach statistical significance.

Conclusions: GA provides no significant advantages over MAC during TAVI.

Keywords: CoreValve; delirium; propofol; transcatheter aortic valve implantation (TAVI).