Impact of conscious sedation and general anesthesia on periprocedural outcomes in Watchman left atrial appendage closure
| Autor: | Jiangtao Yu, Xiao-Xia Liu, Eric Buffle, Caroline Kleinecke, Yamen Mohrez, Johannes Brachmann, Steffen Gloekler, Stephan Achenbach, Steffen Schnupp, Wasim Allakkis |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
business.industry
Sedation Conscious Sedation Atrial fibrillation General Medicine Anesthesia General Postoperative pneumonia medicine.disease Interventional Cardiology Stroke Treatment Outcome Left atrial Anesthesia Atrial Fibrillation Propensity score matching Cohort Humans Medicine Atrial Appendage In patient Cardiac Surgical Procedures medicine.symptom Propensity Score Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiol J |
| ISSN: | 1898-018X 1897-5593 |
| DOI: | 10.5603/cj.a2020.0184 |
| Popis: | Background: Transcatheter left atrial appendage closure (LAAC) is performed either in conscious sedation (CS) or general anesthesia (GA), and limited data exist regarding clinical outcomes for the two approaches. The aim of the study was to analyze the effect of CS versus GA on acute outcomes in a large patient cohort undergoing LAAC with a Watchman occluder. Methods: A cohort of 521 consecutive patients underwent LAAC with Watchman occluders at two centers (REGIOMED hospitals, Germany) between 2012 and 2018. One site performed 303 consecutive LAAC procedures in GA, and the other site performed 218 consecutive procedures in CS. The safety endpoint was a composite of major periprocedural complications and postoperative pneumonia. The efficacy endpoint was defined as device success. Results: After a 1:1 propensity score matching, 196 (CS) vs. 115 (GA) patients could be compared. In 5 (2.6%) cases CS was converted to GA. The primary safety endpoint (3.5% [CS] vs. 7.0% [GA], p = 0.18) and its components (major periprocedural complications: 2.5% vs. 3.5%, p = 0.73; postoperative pneumonia: 2.6% vs. 4.3%, p = 0.51) did not differ between the groups. Also, device success was comparable (96.9% vs. 93.9%, p = 0.24). Conclusions: In patients undergoing LAAC with the Watchman device, conscious sedation and general anesthesia showed comparable device success rates and safety outcomes. The type of anesthesia for LAAC may therefore be tailored to patient comorbidities, operator experience, and hospital logistics. |
| Databáze: | OpenAIRE |
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