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Safety of an algorithm for transcatheter aortic valve replacement procedures with or without anesthesiologist

Title: Safety of an algorithm for transcatheter aortic valve replacement procedures with or without anesthesiologist
Authors: Stettler, R; Roule, V; Glacet, R; Lemaitre, A; Bignon, M; Blanchart, K; Sabatier, R; Merheb, T; Peron, C; Lacote, C; Beygui, F
Source: European Heart Journal ; volume 46, issue Supplement_1 ; ISSN 0195-668X 1522-9645
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Background The growing number of transcatheter aortic valve replacements (TAVR) without adequately growing resources is associated with the risk of patient-mortality while on wait list. The presence of anesthesiologists during TAVR may be a limit to reducing wait times. Purpose We aimed to assess the safety of a stratification algorithm to lead patients with high risk of perioperative complications towards anesthesiologist presence and others to non-anesthesiologist managed analgesia. Methods A total of 1369 patients consecutive patients who underwent trans-femoral TAVR in a tertiary university center and prospectively included in the national TAVI registries were include in the analysis. All patients prior to January 2020 (Phase 1, N=502) underwent TAVR in the presence of anesthesiologist. The algorithm led patients to TAVR with anesthesiologist in the presence of at least one of the following: left ventricular ejection fraction 60 mmHg, stage ≥ 3 pulmonary disease, body mass index ≥ 35 or difficult femoral access after January 2020 (Phase 2). The primary end point (composite of death, myocardial infarction-MI-, stroke, vascular surgery or tamponade) was compared between phases as well as between groups with and without anesthesiologist during phase 2 using a Chi2 test and an adjusted (variables differently distributed between groups with p
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurheartj/ehaf784.3236
Availability: https://doi.org/10.1093/eurheartj/ehaf784.3236; https://academic.oup.com/eurheartj/article-pdf/46/Supplement_1/ehaf784.3236/65216645/ehaf784.3236.pdf
Rights: https://academic.oup.com/pages/standard-publication-reuse-rights
Accession Number: edsbas.58F4C4C8
Database: BASE