Background: Transcatheter aortic valve implantation (TAVI) is used for patients with severe aortic stenosis who are at high risk for surgery. Since these patients are elderly and have comorbidities, their management is of great importance. Objectives: This retrospective study compares two anesthesia techniques during TAVI: sedation (ketamine and propofol) and general anesthesia. Methods: Patients with severe aortic stenosis undergoing TAVI during 2021 in our hospital were retrospectively screened. Demographic data, comorbidities, anesthesia management, complications, and mortality of the patients were obtained from the records. Results: There were 137 patients treated with TAVI; 74 (54%) patients had sedation and 63 (46%) had general anesthesia. When the anesthesia management was evaluated, no significant difference in mortality was observed between the patients who received general anesthesia and sedation. After univariate and multivariate logistic regression analyses were performed to investigate factors having an impact on mortality, anemia (only in univariate analysis) in the whole study population was a statistically significant risk factor for mortality in patients undergoing TAVI (p<0.014). Conclusion: There was no significant difference in mortality in terms of anesthesia management. Anemia was a risk factor for mortality (only in univariate analysis) in the whole study population. We concluded that conscious sedation with ketamine and propofol is effective and safe for TAVI procedures compared to general anesthesia.

中文翻译：

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氯胺酮-异丙酚对经导管主动脉瓣植入术患者的镇静：全身麻醉的比较回顾性研究

背景：经导管主动脉瓣植入术（TAVI）用于手术风险高的严重主动脉瓣狭窄患者。由于这些患者年龄较大且有合并症，因此他们的治疗非常重要。目的：这项回顾性研究比较了 TAVI 期间的两种麻醉技术：镇静（氯胺酮和异丙酚）和全身麻醉。方法：回顾性筛选2021年在我院接受TAVI治疗的重度主动脉瓣狭窄患者。从记录中获得患者的人口统计数据、合并症、麻醉管理、并发症和死亡率。结果：137例患者接受了TAVI治疗； 74 名患者 (54%) 接受了镇静治疗，63 名患者 (46%) 接受了全身麻醉。当评估麻醉管理时，接受全身麻醉和镇静的患者之间的死亡率没有显着差异。在进行单变量和多变量逻辑回归分析以调查影响死亡率的因素后，整个研究人群中的贫血（仅在单变量分析中）是接受 TAVI 的患者死亡的具有统计学意义的危险因素（p<0.014）。结论：麻醉管理方面的死亡率没有显着差异。贫血是整个研究人群死亡的危险因素（仅在单变量分析中）。我们的结论是，与全身麻醉相比，使用氯胺酮和异丙酚进行清醒镇静对于 TAVI 手术来说是有效且安全的。