Clinical Report: Impact of General Anesthesia on Postoperative Results Following TAVI

Overview

This systematic review and meta-analysis evaluates the effects of general anesthesia (GA) on postoperative outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). Findings indicate that GA is associated with increased in-hospital mortality, postoperative pneumonia, procedure time, and length of hospital and ICU stays, while not affecting 30-day mortality or other major complications.

Background

Transcatheter aortic valve implantation (TAVI) has become a widely adopted procedure for treating aortic stenosis, particularly in patients who are elderly or at high surgical risk. The choice of anesthesia during TAVI remains controversial, as different techniques may influence patient outcomes.

Data Highlights

Key Findings

• GA is associated with increased in-hospital mortality (RR = 1.99, P = 0.008).
• GA leads to a higher incidence of postoperative pneumonia (RR = 2.39, P = 0.0009).
• Procedure time is significantly longer in the GA group (MD = 20.22, P < 0.00001).
• Length of hospital stay is increased with GA (MD = 1.43, P < 0.00001).
• ICU stay is also prolonged in patients receiving GA (SMD = 1.91, P < 0.00001).
• No significant differences in 30-day mortality or other major complications between GA and non-GA groups.

Clinical Implications

The findings indicate that GA is associated with increased mortality and complications.

Conclusion

GA is linked to adverse postoperative outcomes in TAVI patients.

Related Resources & Content

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2. Clinical Research in Cardiology, 2026 -- Neurocognition and health-related quality of life in patients randomized to surgical or transcatheter aortic-valve replacement
3. Clinical Research in Cardiology, 2022 -- Decreased Need for Permanent Pacemaker Insertion with Cusp Overlap Technique in Transcatheter Aortic Valve Replacement: A Meta-Analytical Review
4. Clinical Research in Cardiology, 2020 -- Comparison of Antithrombotic Regimens With and Without Clopidogrel Following Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Trials
5. 2025 ESC/EACTS Guidelines for the management of valvular heart disease, 2025
6. American College of Cardiology -- SOLVE-TAVI trial
7. 2025 ESC/EACTS Guidelines for the management of valvular heart disease
8. compariSon of secOnd-generation seLf-expandable vs. balloon-expandable Valves and gEneral vs. local anaesthesia in Transcatheter Aortic Valve Implantation - American College of Cardiology