Patient Selection and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement Performed with Monitored Anesthesia Care versus General Anesthesia

Objective The aim of this study was to compare outcomes of monitored anesthesia care (MAC) vs. general anesthesia(GA) for (TF) TAVR and to describe a selection process for administration of MAC. Design Retrospective analysis of patients who underwent (TF) TAVR under MAC or GA. Setting Department of Cardiac Anesthesia, Albany Medical Center, a tertiary University hospital. Participants Patients selected for (TF) TAVR. Interventions Patients were divided into those who underwent MAC and those who underwent GA. Measurements and Main Results A total of 104 consecutive TF-TAVR patients from 2014-2015 (55% male, mean age 83 years) underwent TF-TAVR under MAC (n=60) or GA (n=37). Seven patients were converted from MAC to GA and were omitted from analysis. There was no statistically significant difference between 30-day mortality and complications between the two groups. The MAC group had significantly shorter median ICU length of stay (48 hrs vs. 74 hrs, p = 0.0002). The MAC group had reduced procedural time (45.5 min vs. 62 min, p = 0.003), operating room time (111 min vs. 153 min, p =