Susanne Eberl

TRANSCATHETER AORTIC VALVE IMPLANTATION UNDER LOCAL ANALGESIA EXCLUSIVELY

Compared to GA, LA shows shorter preparation and procedure time, as well as shorter

hospital stay and causes lower costs.

In our cohort, mean procedural time was 97 min

compared to 120 to 167 min reported with GA. Mean length of hospital stay was shorter (10

days) than reported with GA (11.9–15 days).

6,8,9

Delirium, a predictor of sustained poor cognitive and functional status after hospital

admission

, occurs in 10–60% and up to 90% in the elderly surgical patients. The low rate

of delirium in our fragile patient cohort is promising for the future of TAVI in this ageing

population.

We can conclude that it is safe and feasible to perform transfemoral TAVI procedures

exclusively with local wound infiltration and fluoroscopic guidance. This minimal invasive

approach respecting maximal safety standards may bene t outcome in the elderly high-risk

patient group scheduled for aortic valve replacement.

Table 4.

30-day clinical outcome

All-cause mortality

9 (5.0%)

Immediate procedural mortality

2 (1.1%)

Cardiovascular mortality

8 (4.4%)

MACCE

14 (7.8%)

Myocardial infarction

3 (1.7%)

Stroke

10 (5.6%)

Disabling stroke

6 (3.3%)

Non-disabling stroke

4 (2.2%)

Bleeding

Life threatening bleeding

4 (2.2%)

Major bleeding

30 (16.7%)

Vascular access complication

32 (17.8%)

Major

11 (6.1%)

Minor

21 (11.7%)

Acute kidney injury

Stage 1

18 (10%)

Stage 2

2 (1,1%)

Stage 3

0 (0%)

VARC combined safety end-point

15 (8.3%)

Post-procedural delirium

9 (5.0%)

Data expressed as number (percentage). MACCE, major adverse cardiac and cerebral events; VARC, Valve Academic

Research Consortium