Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center

Few studies to date have assessed the postoperative pulmonary complications after transcatheter aortic valve implantation (TAVI) according to the anesthesia method. The present study aims to compare the effects of general anesthesia (GA) or monitored anesthesia care (MAC) on postoperative outcomes i...

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Autores principales:	Sang-Wook Lee, Sangho Lee, Kyung-Don Hahm
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	conscious sedation transcatheter aortic valve replacement delirium postoperative complications respiration disorders Medicine R
Acceso en línea:	https://doaj.org/article/389dd22bc5d845d980cd168d14502f50
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spelling	oai:doaj.org-article:389dd22bc5d845d980cd168d14502f502021-11-25T18:02:09ZPostoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center10.3390/jcm102253652077-0383https://doaj.org/article/389dd22bc5d845d980cd168d14502f502021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5365https://doaj.org/toc/2077-0383Few studies to date have assessed the postoperative pulmonary complications after transcatheter aortic valve implantation (TAVI) according to the anesthesia method. The present study aims to compare the effects of general anesthesia (GA) or monitored anesthesia care (MAC) on postoperative outcomes in patients undergoing TAVI. This retrospective cohort study included 578 patients who underwent TAVI through the trans-femoral approach between August 2011 and May 2019 at a single tertiary academic center. The primary outcome was postoperative pulmonary complications, which were defined as the occurrence of one or more pulmonary complications, such as respiratory failure, respiratory infection, and radiologic findings, within 7 days after TAVI. Secondary outcomes included postoperative delirium, all-cause 30-day mortality rate, 30-day readmission rate, reoperation rate, vascular complications, permanent pacemaker/implantable cardioverter-defibrillator insertion, length of stay in the ICU, hospital stay, and incidence of stroke. Of the 589 patients, 171 underwent TAVI under general anesthesia (GA), and 418 under monitored anesthesia care (MAC). The incidence of postoperative pulmonary complications was significantly higher in the GA than in the MAC group (17.0% vs. 5.3%, <i>p</i> < 0.001). Anesthetic method significantly affected the occurrence of postoperative pulmonary complications, but not of delirium. ICU stay was significantly shorter in the MAC group, as were operation time, the volume of fluid administered during surgery, heparin dose, transfusion, and inotrope requirements. TAVI under MAC can increase the efficiency of medical resources, reducing the lengths of ICU stay and the occurrence of postoperative pulmonary complications, compared with TAVI under GA.Sang-Wook LeeSangho LeeKyung-Don HahmMDPI AGarticleconscious sedationtranscatheter aortic valve replacementdeliriumpostoperative complicationsrespiration disordersMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5365, p 5365 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	conscious sedation transcatheter aortic valve replacement delirium postoperative complications respiration disorders Medicine R
spellingShingle	conscious sedation transcatheter aortic valve replacement delirium postoperative complications respiration disorders Medicine R Sang-Wook Lee Sangho Lee Kyung-Don Hahm Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center
description	Few studies to date have assessed the postoperative pulmonary complications after transcatheter aortic valve implantation (TAVI) according to the anesthesia method. The present study aims to compare the effects of general anesthesia (GA) or monitored anesthesia care (MAC) on postoperative outcomes in patients undergoing TAVI. This retrospective cohort study included 578 patients who underwent TAVI through the trans-femoral approach between August 2011 and May 2019 at a single tertiary academic center. The primary outcome was postoperative pulmonary complications, which were defined as the occurrence of one or more pulmonary complications, such as respiratory failure, respiratory infection, and radiologic findings, within 7 days after TAVI. Secondary outcomes included postoperative delirium, all-cause 30-day mortality rate, 30-day readmission rate, reoperation rate, vascular complications, permanent pacemaker/implantable cardioverter-defibrillator insertion, length of stay in the ICU, hospital stay, and incidence of stroke. Of the 589 patients, 171 underwent TAVI under general anesthesia (GA), and 418 under monitored anesthesia care (MAC). The incidence of postoperative pulmonary complications was significantly higher in the GA than in the MAC group (17.0% vs. 5.3%, <i>p</i> < 0.001). Anesthetic method significantly affected the occurrence of postoperative pulmonary complications, but not of delirium. ICU stay was significantly shorter in the MAC group, as were operation time, the volume of fluid administered during surgery, heparin dose, transfusion, and inotrope requirements. TAVI under MAC can increase the efficiency of medical resources, reducing the lengths of ICU stay and the occurrence of postoperative pulmonary complications, compared with TAVI under GA.
format	article
author	Sang-Wook Lee Sangho Lee Kyung-Don Hahm
author_facet	Sang-Wook Lee Sangho Lee Kyung-Don Hahm
author_sort	Sang-Wook Lee
title	Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center
title_short	Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center
title_full	Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center
title_fullStr	Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center
title_full_unstemmed	Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center
title_sort	postoperative pulmonary complications after transcatheter aortic valve implantation under monitored anesthesia care versus general anesthesia: retrospective analysis at a single large volume center
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/389dd22bc5d845d980cd168d14502f50
work_keys_str_mv	AT sangwooklee postoperativepulmonarycomplicationsaftertranscatheteraorticvalveimplantationundermonitoredanesthesiacareversusgeneralanesthesiaretrospectiveanalysisatasinglelargevolumecenter AT sangholee postoperativepulmonarycomplicationsaftertranscatheteraorticvalveimplantationundermonitoredanesthesiacareversusgeneralanesthesiaretrospectiveanalysisatasinglelargevolumecenter AT kyungdonhahm postoperativepulmonarycomplicationsaftertranscatheteraorticvalveimplantationundermonitoredanesthesiacareversusgeneralanesthesiaretrospectiveanalysisatasinglelargevolumecenter
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Postoperative Pulmonary Complications after Transcatheter Aortic Valve Implantation under Monitored Anesthesia Care versus General Anesthesia: Retrospective Analysis at a Single Large Volume Center

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