True First-Line Local-Anesthesia Only Protocol for Transfemoral TAVI

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Anesthesiology

Background:

• Transcatheter aortic valve implantation (TAVI) is a common procedure for aortic stenosis.
• General anesthesia is often used, but local anesthesia may be an alternative.

Purpose of the Study:

• To assess the safety and feasibility of TAVI using only local anesthesia as the primary strategy.
• To compare outcomes with TAVI requiring additional sedation or general anesthesia.

Main Methods:

• Retrospective analysis of 215 patients undergoing transfemoral TAVI with local anesthesia only.
• Data collected on baseline characteristics, procedural success, and 30-day outcomes.
• Patients were categorized into local anesthesia only (LA), local anesthesia with sedation (LAS), and general anesthesia (GA) groups.

Main Results:

• TAVI was successful in 98.2% of cases.
• 18.6% required additional sedation, and 3.3% were converted to general anesthesia.
• The LA group had significantly shorter ICU stays (3 days) compared to LAS (5 days) and GA (7 days) groups.

Conclusions:

• TAVI with local anesthesia only is a feasible strategy.
• This approach may offer benefits over routine sedation or general anesthesia, including shorter ICU stays.
• Local anesthesia only can be considered a primary option for many TAVI patients.