Deep sedation versus general anaesthesia for transcatheter mitral valve repair: An individual patient data meta-analysis of observational studies

Artikel in FachzeitschriftForschungbegutachtet

Publikationsdaten


VonAlexander Jobs, Simon Grund, Suzanne de Waha-Thiele, Jakob Ledwoch, Horst Sievert, Tienush Rassaf, Peter Luedike, Malte Kelm, Katharina Hellhammer, Patrick Horn, Ralf Westenfeld, Johannes Patzelt, Harald F. Langer, Philipp Lurz, Steffen Desch, Ingo Eitel, Holger Thiele
OriginalspracheEnglisch
Erschienen inEuroIntervention, 16(16)
Seiten1359-1365
Herausgeber (Verlag)Europa Group
ISSN1774-024X, 1969-6213
DOI/Linkhttps://doi.org/10.4244/EIJ-D-20-00607
PublikationsstatusVeröffentlicht – 03.2021

Aims: To compare general anaesthesia (GA) and deep sedation (DS) with regard to safety and length of intensive care unit (ICU) stay in patients undergoing percutaneous edge-to-edge mitral valve repair (PMVR).

Methods and Results: Four studies comparing GA and DS in patients undergoing PMVR were included in an individual patient data meta-analysis. Data were pooled after multiple imputation. The composite safety endpoint of all-cause death, stroke, pneumonia, or major to life-threatening bleeding occurred in 87 of 626 (13.9%) patients with no difference between patients treated with DS as compared to GA (56 and 31 events in 420 and 206 patients, respectively). In this regard, the odds ratio was 1.27 (95% confidence interval, 0.78 to 2.09; p = 0.338) and 1.26 (95% confidence interval, 0.49 to 3.22; p = 0.496) following the one-stage and two-stage approach, respectively. Length of ICU stay was longer after GA as compared to DS (ratio of days 3.08, 95% confidence interval, 2.18 to 4.36, p < 0.001 and 2.88, 95% confidence interval, 1.45 to 5.73, p = 0.016 following the one-stage and two-stage approach, respectively).

Conclusion: Both, DS and GA might offer a similar safety profile. However, ICU stay seems to be shorter after DS.