Tavi Under Conscious Sedation

TAVI & TAVR Specialists in Mumbai

TAVI under conscious sedation, a beneficial alternative to general anaesthesia

Conscious sedation has been increasingly used in TAVI procedures over time

With deeper sedation, the risks of adverse events and depression of the physiological systems rise. As an alternative to general anaesthesia, conscious sedation has numerous benefits for patients

Minimal sedation Conscious sedation Deep sedation General anaesthesia
Responsiveness Normal response to verbal stimulation Purposeful* response to verbal or tactile stimulation Purposeful*response to repeated or painful stimulation Unarousable even with painful stimulus
Airway Unaffected No intervention required Intervention may be required Intervention may be required
Spontaneous ventilation Unaffected Adequate May be inadequate Frequently in adequate
Cardiovascular function Unaffected Usually maintained Usually maintained May be impaired

Patients who undergo TAVI with conscious sedation may see improved outcomes
compared to those who undergo TAVI with general anaesthesia

OutcomeConscious sedationGeneral anaesthesia
30-day mortality1
(p=0.01)
4.5%
(135/2,943)
6.2%
(123/1,961)
QoL score at 30-day
follow-up
(p<0.001)
9079

TAVI under conscious sedation leads to shorter procedure time and shorter hospital stay compared to TAVI under general anaesthesia

Shorter procedure time

Shorter ICU and hospital stay

Comparable procedural success

Comparable low rates of adverse events
  • Residual PVL
  • Annular rupture
  • MI
  • Stroke
  • Vascular complications
Quality of life scores assessed using the Kansas City Cardiomyopathy 12-question survey. *Data based on observational studies,

Abbrevations: ICU: intensive care unit; MI: myocardial infarction; PVL: paravalvular leak; QoL: quality of life;  
References
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  • Academy of Medical Royal Colleges. Safe Sedation Practice for Healthcare Procedures, October 2013.
  • Hyman MC, et al. Circulation 2017; 136(22): 2132–2140.
  • Toppen W, et al. PLoS ONE 2017; 12(4): e0173777.
  • Eskandari M, et al. Heart 2018; 0: 1–8.
  • Fröhlich G, et al. BMC Medicine 2014; 12: 41–49.
  • Maas EHA, et al. Curr Pharm Des. 2016; 22(13): 1868–1878.
  • Mansoon A, et al. Cureus 2019; 11(6): e4812. 11. Ehret C, et al. BMJ Open 2017; 7: e016321.