Heart valve replacement without general anesthesia

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For some people with a stiff, failing aortic valve, a procedure known as transcatheter aortic valve replacement (TAVR) can fix the problem without surgery. Now, a study suggests that having the procedure done under conscious sedation — in which you remain awake yet relaxed — may be safer than having it done under general anesthesia.

TAVR is a procedure that delivers a new valve to the heart through a catheter that is threaded through an artery in the upper leg. It has traditionally been performed while the person is under general anesthesia and therefore unconscious.

Using data from a national registry, researchers found that over a 15-month period during 2014 and 2015, nearly 16% of TAVR procedures were done under conscious sedation. Compared with people who had general anesthesia, those who remained awake during TAVR had lower death rates, both in the hospital and for 30 days after the procedure. They also had shorter hospital stays. The findings were reported online Sept. 1, 2017, by the journal Circulation.