Abstract
Background Retrograde transcatheter aortic valve implantation (TAVI) can be performed under
local anesthesia (LA) or general anesthesia (GA); however, a wide variation in practice
exists.
Methods PubMed was searched between 2009 and 2013. Data were extracted from eligible studies.
Random-effects meta-analysis was performed using DerSimonian Laird between-study variance.
Results There was no statistically significant difference identified between groups based
on age or EuroSCORE. There was no statistically significant difference seen in all-cause
mortality, or complication rates between groups. Mean procedural duration was 36 minutes
shorter in the LA group (p = 0.001). There was increased vasopressor use in the GA group (odds ratio 3.92; p = 0.017). Mean hospital stay was 3.41 days shorter in the LA group (p = 0.018).
Conclusion Results suggest that the use of LA for retrograde TAVI is feasible. There are several
potential benefits associated, shorter procedural duration, and hospital stay with
lower vasopressor requirements. Further studies and randomized trials are mandatory
to confirm the presented findings and to identify those patients for whom LA would
be appropriate.
Keywords
cardiac - aorta/aortic - anesthesia
