{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T23:21:49Z","timestamp":1767136909063,"version":"build-2238731810"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Monitored anesthesia care (MAC) has become more widely used during transcatheter aortic valve replacement (TAVR) to avoid the complications of general anesthesia (GA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included consecutive patients who underwent transfemoral\u2010TAVR at our institution between January 2012 and April 2017. We compared outcomes with GA versus MAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 998 patients, MAC was used in 43.9%. MAC was associated with shorter procedural time (96.9\u2009\u00b1\u200930.9 vs. 135\u2009\u00b1\u200964.6\u00a0mins;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), fluoroscopy time (20.4\u2009\u00b1\u20098.9 vs. 29\u2009\u00b1\u200918.7\u00a0mins;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), lower contrast volume (45.5\u2009\u00b1\u200927 vs. 60.4\u2009\u00b1\u200943\u2009cc;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), and decreased radiation exposure (12,869\u2009\u00b1\u20098,099 vs. 20,630\u2009\u00b1\u200916,276\u2009cGy\u2010cm\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Patients who underwent MAC had a briefer median (IQR) intensive care unit stay [23.3 (21\u201324) vs. 23.4 (20.8\u201326) hrs;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001], and hospital stay [2 (2, 3) vs. 3 (2\u20136) days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001], and were more frequently discharged to home (93.4% vs. 82.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). MAC was associated with lower mortality at 30\u2009days (0.5% vs. 2.9%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.012; adjHR 0.22, 95% CI 0.06\u20130.82;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.024), but not at 1\u00a0year (11.7% vs. 14.6%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.157) or 3\u2009years (36.8% vs. 38.4%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.433). There were no differences in major adverse cardiac and cerebrovascular events (MACCE) at either 30\u2009days (4.6% vs. 9.3%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.14) or 1\u00a0year (21.1% vs. 21.5%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.653). Similar findings were seen among patients who received newer\u2010generation SAPIEN\u20103 valves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Utilizing MAC and omitting intraprocedural transesophageal echocardiography during TAVR seems to be more efficient without compromising safety. Better TAVR outcomes can be achieved with newer generation valves without needing GA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.29496","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T06:04:13Z","timestamp":1611900253000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparing outcomes of general anesthesia and monitored anesthesia care during\n                    <scp>transcatheter<\/scp>\n                    aortic valve replacement: The Cleveland Clinic Foundation experience"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1763-9340","authenticated-orcid":false,"given":"Yasser","family":"Sammour","sequence":"first","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio 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Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanchit","family":"Chawla","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krystof","family":"Andress","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Unai","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars G.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Yun","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant W","family":"Reed","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrej","family":"Alfirevic","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiva","family":"Sale","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute Cleveland Clinic Foundation  Cleveland 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expands indication for several transcatheter heart valves to patients at low risk for death or major complications associated with open\u2010heart surgery.2019."}],"updated-by":[{"DOI":"10.1002\/ccd.30409","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000}}],"container-title":["Catheterization and Cardiovascular 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