title: Outcome of patients undergoing TAVR with and without the attendance of an anesthesiologist.
abstract: BACKGROUND
  During the last few years there is a shift from performing Transcatheter Aortic Valve Replacement (TAVR) under general anesthesia towards conscious sedation and local anesthesia only. In the vast majority of centers, sedation is guided by a qualified anesthesiologist. In our center, all TAVR procedures are being performed under local anesthesia and mild sedation, however, since September 2014, a large portion of TAVR procedures are being performed under local anesthesia without the presence of an anesthesiologist. Here we compare 30days outcome of patients undergoing TAVR with and without the presence of anesthesiologist in the catheterization laboratory.
  
  
  RESULTS
  From September 2014 through April 2016, 324 patients (mean age 82.8±6) with severe symptomatic aortic stenosis were assigned to transfemoral TAVR with (150 patients) or without (174 patients) the attendance of an anesthesiologist. Baseline clinical and echocardiographic characteristics were similar between the groups. No difference in procedural and 30-day mortality, vascular complications, and major/life threatening bleeding were observed between the groups (p>0.1, for all).
  
  
  CONCLUSIONS
  The presence of an anesthesiologist in the catheterization laboratory during transfemoral TAVR procedures did not significantly change 30-day outcome.
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. Electronic address: maayan.konigstein@gmail.com.
authors.forename: Maayan
authors.initials: M
authors.lastname: Konigstein
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Ben-Shoshan
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Zahler
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Flint
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Gilad
authors.initials: G
authors.lastname: Margolis
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Granot
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Galit
authors.initials: G
authors.lastname: Aviram
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Halkin
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Banai
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Finkelstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000401:mortality / Q000639:trends*; D000072080:Anesthesiologists / Q000639:trends*; D015331:Cohort Studies; D016292:Procedural Sedation / Q000401:mortality / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D016896:Treatment Outcome
keywords: Anesthesia; Conscious sedation; Transcatheter Aortic Valve Replacement