TY - JOUR
T1 - Deep sedation versus general anaesthesia for transcatheter mitral valve repair
T2 - An individual patient data meta-analysis of observational studies
AU - Jobs, Alexander
AU - Grund, Simon
AU - De Waha-Thiele, Suzanne
AU - Ledwoch, Jakob
AU - Sievert, Horst
AU - Rassaf, Tienush
AU - Luedike, Peter
AU - Kelm, Malte
AU - Hellhammer, Katharina
AU - Horn, Patrick
AU - Westenfeld, Ralf
AU - Patzelt, Johannes
AU - Langer, Harald F.
AU - Lurz, Philipp
AU - Desch, Steffen
AU - Eitel, Ingo
AU - Thiele, Holger
N1 - Publisher Copyright:
© Europa Digital & Publishing 2021. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Aims: The aim of this meta-analysis was 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-toedge 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 (OR) was 1.27 (95% confidence interval [CI]: 0.78 to 2.09; p=0.338) and 1.26 (95% CI: 0.49 to 3.22; p=0.496) following the onestage and two-stage approach, respectively. Length of ICU stay was longer after GA as compared to DS (ratio of days 3.08, 95% CI: 2.18 to 4.36, p<0.001, and 2.88, 95% CI: 1.45 to 5.73, p=0.016, following the one-stage and two-stage approach, respectively). Conclusions: Both DS and GA might offer a similar safety profile. However, ICU stay seems to be shorter after DS.
AB - Aims: The aim of this meta-analysis was 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-toedge 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 (OR) was 1.27 (95% confidence interval [CI]: 0.78 to 2.09; p=0.338) and 1.26 (95% CI: 0.49 to 3.22; p=0.496) following the onestage and two-stage approach, respectively. Length of ICU stay was longer after GA as compared to DS (ratio of days 3.08, 95% CI: 2.18 to 4.36, p<0.001, and 2.88, 95% CI: 1.45 to 5.73, p=0.016, following the one-stage and two-stage approach, respectively). Conclusions: Both DS and GA might offer a similar safety profile. However, ICU stay seems to be shorter after DS.
UR - http://www.scopus.com/inward/record.url?scp=85103474102&partnerID=8YFLogxK
U2 - 10.4244/EIJ-D-20-00607
DO - 10.4244/EIJ-D-20-00607
M3 - Journal articles
C2 - 33046436
AN - SCOPUS:85103474102
SN - 1774-024X
VL - 16
SP - 1359
EP - 1365
JO - EuroIntervention
JF - EuroIntervention
IS - 16
ER -
