Conscious sedation better than general anesthesia for TAVR

USA: The use of conscious sedation (CS) in patients undergoing transcatheter aortic valve replacement (TAVR) is associated with improved outcomes compared with general anesthesia (GA), according to a recent study. The study, published in the journal JACC: Cardiovascular Interventions found that compared with GA, CS was associated with reduced in-hospital mortality and 30-day mortality, as well as shorter hospital length of stay and more frequent discharge to home.

The proportion of TAVR using conscious sedation has increased from 33% to 64% between January 2016 and March 2019. Despite this, contemporary data on utilization patterns are lacking, and existing studies evaluating the impact of sedation choice on outcomes may suffer from unmeasured confounding. Neel M. Butala, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, and colleagues examined variation in the use of CS for TAVR across hospitals and over time and to evaluate outcomes of CS compared with GA using instrumental variable analysis, a quasi-experimental method to control for unmeasured confounding.