{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:59:42Z","timestamp":1785117582021,"version":"3.55.0"},"reference-count":26,"publisher":"IMR Press","issue":"5","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background: Patients undergoing transfemoral aortic valve replacement are particularly vulnerable and require a more sophisticated anesthetic therapeutic approach. According to the literature, no study has directly compared general anaesthesia with conscious analgosedation using postoperative infections as the primary endpoint. Methods: Patients undergoing transcatheter aortic valve implantation (TAVI) were analyzed retrospectively. A total of 3313 patients from a large heart center in Western Europe were included in this study. One group received general anaesthesia, and the other group received analgosedation for TAVI. The primary outcome was postinterventional pneumonia; secondary outcomes included myocardial infarction, renal failure, stroke, and 30-day mortality. Propensity score matching using 16 matching criteria yielded over 1000 pairs. Results: No difference was observed in the incidence of postinterventional pneumonia (p = 0.148). The occurrence of myocardial infarction (p = 0.2) and stroke (p = 0.4) also did not differ significantly between the two groups. In contrast, the need for transient renal replacement therapy (p = 0.02) and 30-day mortality (p = 0.02) were lower in the analgosedation group. Conclusions: Regarding postinterventional pneumonia, general anaesthesia can be used as safely as analgosedation during TAVI. However, since renal failure requiring temporary replacement therapy and mortality are both increased with general anaesthesia, analgosedation should be the standard of care for TAVI in high-volume centers. The anesthetic regimen must be determined on an individual basis and discussed during the heart team briefing. The conversion to, or primary use of, general anaesthesia when clinically indicated is safe. Overall, ensuring the continuous presence of a senior consultant anesthetist, specifically trained in cardiac anaesthesia, throughout the procedure is essential.<\/jats:p>","DOI":"10.31083\/rcm48924","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:28:22Z","timestamp":1785115702000},"source":"Crossref","is-referenced-by-count":0,"title":["General Anaesthesia Versus Conscious Sedation in Transcatheter Aortic Valve Implantation: Differences in Pulmonary Infections"],"prefix":"10.31083","volume":"27","author":[{"given":"Astrid","family":"Bergmann","sequence":"first","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Warkentin","sequence":"additional","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Hildebrandt","sequence":"additional","affiliation":[{"name":"Telehealth Competence Center (TCC), 22083 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janis","family":"Fliegenschmidt","sequence":"additional","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai","family":"Hulde","sequence":"additional","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Rudolph","sequence":"additional","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smita","family":"Scholtz","sequence":"additional","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Piper","sequence":"additional","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Bleiziffer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Zentralklinik Bad Berka, Rh\u00f6n Klinikum AG, 99438 Bad Berka, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"von Dossow","sequence":"additional","affiliation":[{"name":"Ruhr-University Bochum, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"},{"name":"University Bielefeld, Medical Center East Westphalia-Lippe, Heart- and Diabetes-Center, 32545 Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Vigelius-Rauch U, Zajonz T, Sander M. Anesthesiological implications of minimally invasive valve interventions: Transcatheter aortic valve implantation, clip reconstruction on the mitral and tricuspid valve. Anaesthesist. 2021; 70: 97\u2013111.  (In German)","DOI":"10.1007\/s00101-020-00847-x"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Sousa-Uva M, Neumann FJ, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC\/EACTS Guidelines on myocardial revascularization. European Journal of Cardio-Thoracic Surgery. 2019; 55: 4\u201390.","DOI":"10.1093\/ejcts\/ezy289"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP III, Fleisher LA, et al. 2017 AHA\/ACC Focused Update of the 2014 AHA\/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2017; 70: 252\u2013289.","DOI":"10.1016\/j.jacc.2017.03.011"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Beckmann A, Funkat AK, Lewandowski J, Frie M, Ernst M, Hekmat K, et al. German Heart Surgery Report 2016: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery. The Thoracic and Cardiovascular Surgeon. 2017; 65: 505\u2013518.","DOI":"10.1055\/s-0037-1606603"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Frank J, Ryll A. Demographic Change, Morbidity and Utilization: Projection of the Outpatient Volume of Services. Gesundheitswesen. 2015; 77: 932\u2013938.  (In German)","DOI":"10.1055\/s-0034-1390417"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Martin AN, Hoagland DL, Turrentine FE, Jones RS, Zaydfudim VM. Safety of Major Abdominal Operations in the Elderly: A Study of Geriatric-Specific Determinants of Health. World Journal of Surgery. 2020; 44: 2592\u20132600.","DOI":"10.1007\/s00268-020-05515-0"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Eamer G, Al-Amoodi MJH, Holroyd-Leduc J, Rolfson DB, Warkentin LM, Khadaroo RG. Review of risk assessment tools to predict morbidity and mortality in elderly surgical patients. American Journal of Surgery. 2018; 216: 585\u2013594.","DOI":"10.1016\/j.amjsurg.2018.04.006"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients. Journal of the American College of Surgeons. 2006; 203: 865\u2013877.","DOI":"10.1016\/j.jamcollsurg.2006.08.026"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. 2021 ESC\/EACTS Guidelines for the Management of Valvular Heart Disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal. 2022; 43: 561\u2013632.","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Windecker S, Okuno T, Unbehaun A, Mack M, Kapadia S, Falk V. Which patients with aortic stenosis should be referred to surgery rather than transcatheter aortic valve implantation? European Heart Journal. 2022; 43: 2729\u20132750.","DOI":"10.1093\/eurheartj\/ehac105"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Corcoran TB, Hillyard S. Cardiopulmonary aspects of anaesthesia for the elderly. Best Practice & Research. Clinical Anaesthesiology. 2011; 25: 329\u2013354.","DOI":"10.1016\/j.bpa.2011.07.002"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Zaugg M, Lucchinetti E. Respiratory function in the elderly. Anesthesiology Clinics of North America. 2000; 18: 47\u201358, vi.","DOI":"10.1016\/s0889-8537(05)70148-6"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Kawami N, Iwakiri K, Sano H, Tanaka Y, Sakamoto C. Effects of aging and acid reflux on esophageal motility. Digestion. 2015; 91: 181\u2013186.","DOI":"10.1159\/000367650"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Huang S, Liao Z, Chen A, Wang J, Xu X, Zhang L. Effect of carotid corrected flow time combined with perioperative fluid therapy on preventing hypotension after general anesthesia induction in elderly patients: a prospective cohort study. International Journal of Surgery. 2024; 110: 799\u2013809.","DOI":"10.1097\/JS9.0000000000000863"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Cohen C, Le Goff O, Soysouvanh F, Vasseur F, Tanou M, Nguyen C, et al. Glomerular endothelial cell senescence drives age-related kidney disease through PAI-1. EMBO Molecular Medicine. 2021; 13: e14146.","DOI":"10.15252\/emmm.202114146"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Petronio AS, Giannini C, Carlo MD, Bedogni F, Colombo A, Tamburino C, et al. Anesthetic Management of Transcatheter Aortic Valve Implantation: Results from the Italian CoreValve Registry. 2016. Available at: https:\/\/eurointervention.pcronline.com\/article\/anaesthetic-management-of-transcatheter-aortic-valve-implantation-results-from-the-italian-corevalve-registry (Accessed: 1 December 2025).","DOI":"10.4244\/EIJY15M03_05"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Thiele H, Kurz T, Feistritzer HJ, Stachel G, Hartung P, Lurz P, et al. General Versus Local Anesthesia With Conscious Sedation in Transcatheter Aortic Valve Implantation: The Randomized SOLVE-TAVI Trial. Circulation. 2020; 142: 1437\u20131447.","DOI":"10.1161\/CIRCULATIONAHA.120.046451"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Dimitriadis Z, Scholtz W, B\u00f6rgermann J, Wiemer M, Piper C, Vlachojannis M, et al. Impact of closure devices on vascular complication and mortality rates in TAVI procedures. International Journal of Cardiology. 2017; 241: 133\u2013137.","DOI":"10.1016\/j.ijcard.2017.01.088"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Potratz M, Mohemed K, Omran H, Gortamashvili L, Friedrichs KP, Scholtz W, et al. Hemodynamic Performance of Two Current-Generation Transcatheter Heart Valve Prostheses in Severely Calcified Aortic Valve Stenosis. Journal of Clinical Medicine. 2022; 11: 4570.","DOI":"10.3390\/jcm11154570"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Yilmaz N, Gul YG, Ugurlucan M. Sedation with Ketamine-Propofol in Patients Undergoing Transcatheter Aortic Valve Implantation: A Comparative Retrospective Study on General Anesthesia. Current Vascular Pharmacology. 2024; 22: 266\u2013272.","DOI":"10.2174\/0115701611274790231221044147"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Feistritzer HJ, Kurz T, Vonthein R, Schr\u00f6der L, Stachel G, Eitel I, et al. Effect of Valve Type and Anesthesia Strategy for TAVR: 5-Year Results of the SOLVE-TAVI Trial. Journal of the American College of Cardiology. 2025; 85: 74\u201382.","DOI":"10.1016\/j.jacc.2024.09.007"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Morcos M, Burgdorf C, Vukadinivikj A, Mahfoud F, Latus J, Persson PB, et al. Kidney injury as post-interventional complication of TAVI. Clinical Research in Cardiology. 2021; 110: 313\u2013322.","DOI":"10.1007\/s00392-020-01732-8"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Chatani K, Abdel-Wahab M, W\u00fcbken-Kleinfeld N, Gordian K, P\u00f6tzing K, Mostafa AE, et al. Acute kidney injury after transcatheter aortic valve implantation: Impact of contrast agents, predictive factors, and prognostic importance in 203 patients with long-term follow-up. Journal of Cardiology. 2015; 66: 514\u2013519.","DOI":"10.1016\/j.jjcc.2015.02.007"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Aslan S, G\u00fcner A, Demir AR, Y\u0131lmaz E, Aslan AF, \u00c7elik \u00d6, et al. Conscious sedation versus general anesthesia for transcatheter aortic valve implantation in patients with severe chronic obstructive pulmonary disease. Perfusion. 2023; 38: 186\u2013192.","DOI":"10.1177\/02676591211045801"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Gim\u00e9nez-Mil\u00e0 M, Manzano-Valls A, Abdul-Jawad O, Arguis MJ, Brugaletta S, Carnaval T, et al. High-Flow Nasal Oxygenation During Sedation for Transcatheter Aortic Valve Replacement: The HIGH-OXY-TAVR Randomised-Controlled Trial. Journal of Clinical Medicine. 2025; 14: 8347.","DOI":"10.3390\/jcm14238347"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Balanika M, Smyrli A, Samanidis G, Spargias K, Stavridis G, Karavolias G, et al. Anesthetic management of patients undergoing transcatheter aortic valve implantation. Journal of Cardiothoracic and Vascular Anesthesia. 2014; 28: 285\u2013289.","DOI":"10.1053\/j.jvca.2013.07.010"}],"container-title":["Reviews in Cardiovascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/27\/5\/10.31083\/RCM48924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:28:52Z","timestamp":1785115732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/27\/5\/10.31083\/RCM48924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1530-6550(26)02907-0"],"URL":"https:\/\/doi.org\/10.31083\/rcm48924","relation":{},"ISSN":["1530-6550","2153-8174"],"issn-type":[{"value":"1530-6550","type":"print"},{"value":"2153-8174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"article-number":"48924"}}