Transcatheter Aortic Valve Implantation (TAVI): Is General Anaesthesia a
Necessity?
Abstract
Transcatheter Aortic Valve Implantation (TAVI) has emerged over the last
decade and has become a viable treatment option for those with severe
symptomatic aortic stenosis (AS). The numbers of TAVI that are being
performed in centres across the world is rising rapidly, and
revolutionising treatment for AS and steering away from the need for
open heart surgery. TAVI has been targeted for those who are deemed high
risk to undergo open heart surgery such as the elderly, frail, or those
with multiple co-morbidities. General anaesthesia (GA) has been used to
facilitate TAVI especially when the procedure was in its infancy. The
use of GA comes with its own set of risks such as haemodynamic
compromise, risk for aspiration, longer procedure time and
post-operative nausea and vomiting. These side effects and or
complications may not be tolerated well in those who are elderly or have
numerous co-morbidities. This article seeks to understand the outcomes
of patients who undergo TAVI with the support of sedation and local
anaesthesia (LA) in comparison to those who received GA.