{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:12:43Z","timestamp":1787026363272,"version":"build-2736575974"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transcatheter aortic valve implantation (TAVI) has become a preferred treatment for severe aortic stenosis in high-risk patients. In China, general anesthesia (GA) remains the standard; however, monitored anesthesia care (MAC) offers a less-invasive alternative. In this study, we compared the outcomes between MAC and GA in transfemoral TAVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the data from 106 consecutive patients (54 MAC, 52 GA) who underwent TAVI at a The Second Affiliated Hospital of Harbin Medical University from January 2021 to November 2023. MAC involved administration of a combination of local anesthesia with dexmedetomidine\/remifentanil sedation, whereas GA involved endotracheal intubation. We compared procedural metrics, complications, and lengths of hospital stays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The baseline characteristics were comparable between the groups (mean age: 70.3\u2009\u00b1\u20097.3 years, 46% with reduced ejection fraction). The MAC group showed shorter procedure times (102\u2009\u00b1\u200925 vs. 145\u2009\u00b1\u200942\u2005min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001) and hospital stays (10.5\u2009\u00b1\u20093.7 vs. 14.1\u2009\u00b1\u20095.1 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001), compared with the GA group. Safety outcomes were similar between the groups: 30-day mortality (5.8% vs. 7.4% in the MAC and GA groups, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.734), stroke (1.9% in both groups), and major vascular complications (3.8% vs. 5.6%). The GA group had higher valve-in-valve rates (13% vs. 1.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024) and postoperative hypotension (4 vs. 0 patients), compared with the MAC group. Pacemaker implantation was more frequent in the MAC group vs. the GA group (13% vs. 3.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.229).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of MAC for TAVI is comparably safe to using GA, with potential advantages in recovery speed and resource utilization. A heart team approach, including cardiac anesthesiologists, is critical for optimal patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2025.1652045","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T12:37:04Z","timestamp":1764074224000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical outcomes of monitored anesthesia care vs. general anesthesia in transfemoral transcatheter aortic valve implantation: a single-center retrospective study"],"prefix":"10.3389","volume":"12","author":[{"given":"Haoran","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1016\/j.jacc.2006.01.049","article-title":"Treatment of calcific aortic stenosis with the percutaneous heart valve: mid-term follow-up from the initial feasibility studies: the French experience","volume":"47","author":"Cribier","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.jacc.2007.04.047","article-title":"Percutaneous aortic valve replacement for severe aortic stenosis in high-risk patients using the second- and current third-generation self-expanding CoreValve prosthesis: device success and 30-day clinical outcome","volume":"50","author":"Grube","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the heart failure association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"13458","DOI":"10.1038\/s41598-023-39300-5","article-title":"Prospective association of general anesthesia with risk of cognitive decline in a Chinese elderly community population","volume":"13","author":"Li","year":"2023","journal-title":"Sci Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/S2213-2600(18)30294-7","article-title":"Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study","volume":"7","author":"Kirmeier","year":"2019","journal-title":"Lancet Respir Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1016\/j.jcin.2014.04.005","article-title":"Comparison of transfemoral transcatheter aortic valve replacement performed in the catheterization laboratory (minimalist approach) versus hybrid operating room (standard approach): outcomes and cost analysis","volume":"7","author":"Babaliaros","year":"2014","journal-title":"JACC Cardiovasc Interv"},{"key":"B7","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1016\/j.jcin.2013.04.003","article-title":"Management of vascular access in transcatheter aortic valve replacement: part 1: basic anatomy, imaging, sheaths, wires, and access routes","volume":"6","author":"Toggweiler","year":"2013","journal-title":"JACC Cardiovasc Interv"},{"key":"B8","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.bpa.2009.12.001","article-title":"Perioperative modifications of respiratory function","volume":"24","author":"Duggan","year":"2010","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1111\/j.1365-2044.2011.06651.x","article-title":"Association of Anaesthetists of Great Britain and Ireland, British Association of Day Surgery. 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