Minimalist Approach to Cardiac Anesthesia in Patients Undergoing Transcatheter Aortic Valve Replacement (TAVR)

Minneapolis Heart Institute Foundation® quality improvement review finds TAVR performed with conscious sedation led to significant reductions in length-of-stay and hospital costs without affecting the safety and outcomes of the procedure.

Minneapolis, MN – March 10, 2017 – Transcatheter therapy for aortic stenosis continues to evolve with the adoption of methods intended to maximize efficacy, safety and patient recovery. Researchers at the Valve Science Center at Minneapolis Heart Institute Foundation® recently conducted quality improvement review to examine the impact of the use of minimal anesthesia with conscious sedation in patients with severe, symptomatic aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).

Using a multidisciplinary collaboration, a program was initiated to perform transfemoral TAVR with conscious sedation (CS) to treat patients with native valve AS. Clinical outcomes for the first 50 patients treated with CS were compared to 50 control patients who had undergone TAVR with general anesthesia (GA) immediately preceding CS implementation. The two patient groups were similar with respect to age, hemodynamic severity of AS, symptom status and frailty. However, in comparison to GA patients, those who had TAVR with CS had shorter median procedure time and hospital length-of-stay (LOS). Procedural success with TAVR and major adverse complications were similar between the groups. Overall, implementation of TAVR with CS led to a $2,833 reduction in median total variable costs per treated patient. Researchers concluded the implementation of a multidisciplinary program that enabled TAVR to be performed with CS led to significant reductions in LOS and hospital costs, without affecting the effectiveness and safety of the procedure.

Marcus Burns, DNP, principal investigator at the Minneapolis Heart Institute Foundation notes, “The evidence and insight gathered in this analysis supports a novel shift in how we manage our transfemoral TAVR patient population going forward.” He goes on to say, “Conscious sedation, with its ability to maximize the ease of recovery from TAVR procedures, is a huge advancement for the many patients afflicted with aortic stenosis who seek treatment at our facility”. To date, researchers at the Valve Science Center at Minneapolis Heart Institute Foundation® have performed over 120 conscious sedation TF-TAVR’s since February 2016. “While interest in using conscious sedation for TAVR is steadily growing and a majority of centers have not yet adopted or just are beginning to adopt this approach in its true form”, said Burns.

The researchers will present the results at the American College of Cardiology Annual Scientific Session & Expo this month.

 

About the Minneapolis Heart Institute Foundation®

The Minneapolis Heart Institute Foundation (MHIF) strives to create a world without heart and vascular disease. To achieve this bold vision, it is dedicated to improving the cardiovascular health of individuals and communities through innovative research and education.

  • Scientific Innovation and Research — MHIF is a recognized research leader in the broadest range of cardiovascular medicine and population health initiatives. Each year MHIF leads more than 175 active research projects and publishes more than 175 peer-reviewed abstracts. Cardiologists, hospitals and communities around the world adopt MHIF protocols to save lives, improve care and create healthier living opportunities.
  • Education and Outreach — MHIF provides more than 10,000 hours of education each year putting its research into practice to improve outcomes. And, MHIF leads cutting-edge, transformative population health research to connect, engage, inform and empower individuals and communities to improve their health.

The Minneapolis Heart Institute Foundation’s work is funded by generous donors and sponsors and supports research initiatives of Minneapolis Heart Institute® at Abbott Northwestern Hospital.

Minneapolis Heart Institute® physicians provide care for patients at Abbott Northwestern Hospital in Minneapolis and at 38 community sites across Minnesota and western Wisconsin.