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Related Concept Videos

Stages of General Anesthesia01:22

Stages of General Anesthesia

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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Related Experiment Video

Updated: Jun 17, 2025

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Zero-Contrast Conscious Sedation Transcatheter Aortic Valve Replacement-Keeping It Safe and Simple.

Bishesh Shrestha1, Harshith Thyagaturu1, John Kelley2

  • 1Department of Cardiology, Bassett Medical Center, Cooperstown, New York.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 12, 2024
PubMed
Summary

A novel technique for contrast-free transcatheter aortic valve replacement using transthoracic echocardiography under conscious sedation proved safe and effective. This approach minimizes renal injury risk and the need for transesophageal echocardiograms, offering a viable alternative for heart teams.

Keywords:
Contrast freeTranscatheter aortic valve replacementTransthoracic echocardiography

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Area of Science:

  • Cardiology
  • Medical Devices
  • Echocardiography

Background:

  • Transcatheter aortic valve replacement (TAVR) traditionally involves contrast agents and often transesophageal echocardiography (TEE).
  • Renal injury is a significant complication associated with contrast use in TAVR.
  • Conscious sedation is preferred by some patients and clinicians over general anesthesia.

Purpose of the Study:

  • To evaluate a novel, contrast-free TAVR technique guided by transthoracic echocardiography (TTE) under conscious sedation.
  • To assess the feasibility, safety, and efficacy of this minimally invasive approach.
  • To compare outcomes with traditional TAVR methods, focusing on renal protection.

Main Methods:

  • A case series of 4 patients undergoing TAVR.
  • Utilization of a novel technique employing TTE for procedural guidance.
  • Performance of TAVR under conscious sedation without the use of iodinated contrast agents.

Main Results:

  • Successful implantation of TAVR in all 4 patients using the novel technique.
  • Outcomes regarding mortality, cerebrovascular accident, and heart block were comparable to traditional TAVR.
  • Demonstrated minimization of renal injury risk due to the absence of contrast media.

Conclusions:

  • Contrast-free TAVR guided by TTE under conscious sedation is technically feasible, safe, and effective.
  • This approach reduces the risk of renal injury and eliminates the need for TEE.
  • Offers a valuable alternative for select patients undergoing TAVR, enhancing procedural safety and patient comfort.