Research Assessment #3

Date - October 3, 2019

Study - Interventional Cardiology

Citation - Fröhlich, Georg M, et al. “Local versus General Anesthesia for Transcatheter

Aortic Valve Implantation (TAVR) – Systematic Review and Meta-Analysis.” BMC

Medicine, vol. 12, no. 1, Oct. 2014, doi:10.1186/1741-7015-12-41.

Analysis - This study was made to find if there was a benefit to either monitored anesthetic care

which is a form of local anesthetic (MAC) or general anesthetic (GA) for the transcatheter aortic

valve repair (TAVR). The study took previous medical literature as well as 1542 patients during

their study and compared not only the patients experience but also what the literature between

2005 to 2013 and compiled that data to see complications and hospital times with MAC and GA.

What was interesting was how not only was MAC and GA compared but TAVR was compared

to the conventional valve replacement surgery. This case study brought into question how TAVR

would better benefit patients over the traditional valve replacements. IT found that currently

TAVR is best for a high risk patient or that conventional surgery is not possible so they would

resort to TAVR and going through the femoral artery. However that was not the main focus but

in the study it was determined that MAC led to a decreased hospital stay and decreased

procedure time which better benefitted the patient as it reduced the risk of nosocomial infections

and higher mortality rates. MAC and GA were not found to be any different in 30-day mortality

however even with the reduced time and stay in hospitals. Which is interesting as GA normally

done with mechanical ventilation is associated with pneumonia, hemodynamic compromise,

where more than one vital is out of range and is characterized with advanced heart failure and

circulatory shock due to perfusion failure. Also the need for extensive catecholamine use where
heart rate blood pressure, breathing rate and muscle strength are greatly increased and blood

better travels to major organs and not the skin as much. Now for the best part why was this worth

my time and how can I use it in my life? Well for one the case study directly relates to one of my

interview at presbyterian hospital as their two most common procedures are mitraclip and TAVR

thus allowing me to better understand their procedure and allows me to ask follow up questions

during interviews. It also introduced me to even more words that i will need to know in the clinic

which before this study I would not be able to even to comprehend.