أعرض في EDS

Patient Selection and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement Performed with Monitored Anesthesia Care Versus General Anesthesia

التفاصيل البيبلوغرافية
العنوان:	Patient Selection and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement Performed with Monitored Anesthesia Care Versus General Anesthesia
المؤلفون:	Michael Welljams-Dorof, John Cagino, Constantine M. Poulos, Nathapong Arunakul, Kevin Roberts, Christopher Ursillo, Augustine Delago, Paul J. Feustel, Natalie Bruno, Mikhail Torosoff, Sridhar R. Musuku, Saroj Pani, Asim Raja
المصدر:	Journal of Cardiothoracic and Vascular Anesthesia. 31:2049-2054
بيانات النشر:	Elsevier BV, 2017.
سنة النشر:	2017
مصطلحات موضوعية:	Male, medicine.medical_specialty, Transcatheter aortic, medicine.medical_treatment, Anesthesia, General, 030204 cardiovascular system & hematology, law.invention, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, law, Monitoring, Intraoperative, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Patient Selection, Significant difference, Retrospective cohort study, University hospital, Intensive care unit, Surgery, Femoral Artery, Treatment Outcome, Anesthesiology and Pain Medicine, Anesthesia, Female, Cardiology and Cardiovascular Medicine, business, Resource utilization
الوصف:	Objective The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. Design Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. Setting Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. Participants Patients selected for TF-TAVR. Interventions Patients were divided into those who underwent MAC and those who underwent GA. Measurements and Main Results The study comprised 104 consecutive patients (55% male, mean age 83 years) who underwent TF-TAVR under MAC (n = 60) or GA (n = 37) from 2014 to 2015. Seven patients were converted from MAC to GA and were omitted from analysis. There was no statistically significant difference between 30-day mortality and complications between the 2 groups. The MAC group had a significantly shorter median intensive care unit length of stay (48 h v 74 h, p = 0.0002). The MAC group also demonstrated reduced procedural time (45.5 min v 62 min, p = 0.003); operating room time (111 min v 153 min, p = Conclusions Patient selection for TF-TAVR with MAC can be formalized and implemented successfully. MAC allows for the minimizing of patient exposure to unnecessary interventions and improving resource utilization in suitable TAVR patients. Selection requires a multidisciplinary clinical decision-making process. MAC demonstrates good outcomes compared with GA, yet it is important to have a cardiac anesthesiologist present in the event of emergency conversion to GA.
تدمد:	1053-0770
الوصول الحر:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dc0602f0a42f25e76ba08457f7fb24b0Test https://doi.org/10.1053/j.jvca.2017.04.005Test
حقوق:	CLOSED
رقم الانضمام:	edsair.doi.dedup.....dc0602f0a42f25e76ba08457f7fb24b0
قاعدة البيانات:	OpenAIRE

ResultId	1
Header	edsair OpenAIRE edsair.doi.dedup.....dc0602f0a42f25e76ba08457f7fb24b0 842 3 unknown 842.150634765625
PLink	https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=edsair&AN=edsair.doi.dedup.....dc0602f0a42f25e76ba08457f7fb24b0&custid=s6537998&authtype=sso
FullText	Array ( [Availability] => 0 )
Items	Array ( [Name] => Title [Label] => Title [Group] => Ti [Data] => Patient Selection and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement Performed with Monitored Anesthesia Care Versus General Anesthesia ) Array ( [Name] => Author [Label] => Authors [Group] => Au [Data] => <searchLink fieldCode="AR" term="%22Michael+Welljams-Dorof%22">Michael Welljams-Dorof</searchLink><br /><searchLink fieldCode="AR" term="%22John+Cagino%22">John Cagino</searchLink><br /><searchLink fieldCode="AR" term="%22Constantine+M%2E+Poulos%22">Constantine M. Poulos</searchLink><br /><searchLink fieldCode="AR" term="%22Nathapong+Arunakul%22">Nathapong Arunakul</searchLink><br /><searchLink fieldCode="AR" term="%22Kevin+Roberts%22">Kevin Roberts</searchLink><br /><searchLink fieldCode="AR" term="%22Christopher+Ursillo%22">Christopher Ursillo</searchLink><br /><searchLink fieldCode="AR" term="%22Augustine+Delago%22">Augustine Delago</searchLink><br /><searchLink fieldCode="AR" term="%22Paul+J%2E+Feustel%22">Paul J. Feustel</searchLink><br /><searchLink fieldCode="AR" term="%22Natalie+Bruno%22">Natalie Bruno</searchLink><br /><searchLink fieldCode="AR" term="%22Mikhail+Torosoff%22">Mikhail Torosoff</searchLink><br /><searchLink fieldCode="AR" term="%22Sridhar+R%2E+Musuku%22">Sridhar R. Musuku</searchLink><br /><searchLink fieldCode="AR" term="%22Saroj+Pani%22">Saroj Pani</searchLink><br /><searchLink fieldCode="AR" term="%22Asim+Raja%22">Asim Raja</searchLink> ) Array ( [Name] => TitleSource [Label] => Source [Group] => Src [Data] => <i>Journal of Cardiothoracic and Vascular Anesthesia</i>. 31:2049-2054 ) Array ( [Name] => Publisher [Label] => Publisher Information [Group] => PubInfo [Data] => Elsevier BV, 2017. ) Array ( [Name] => DatePubCY [Label] => Publication Year [Group] => Date [Data] => 2017 ) Array ( [Name] => Subject [Label] => Subject Terms [Group] => Su [Data] => <searchLink fieldCode="DE" term="%22Male%22">Male</searchLink><br /><searchLink fieldCode="DE" term="%22medicine%2Emedical%5Fspecialty%22">medicine.medical_specialty</searchLink><br /><searchLink fieldCode="DE" term="%22Transcatheter+aortic%22">Transcatheter aortic</searchLink><br /><searchLink fieldCode="DE" term="%22medicine%2Emedical%5Ftreatment%22">medicine.medical_treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Anesthesia%2C+General%22">Anesthesia, General</searchLink><br /><searchLink fieldCode="DE" term="%22030204+cardiovascular+system+%26+hematology%22">030204 cardiovascular system & hematology</searchLink><br /><searchLink fieldCode="DE" term="%22law%2Einvention%22">law.invention</searchLink><br /><searchLink fieldCode="DE" term="%22Transcatheter+Aortic+Valve+Replacement%22">Transcatheter Aortic Valve Replacement</searchLink><br /><searchLink fieldCode="DE" term="%2203+medical+and+health+sciences%22">03 medical and health sciences</searchLink><br /><searchLink fieldCode="DE" term="%220302+clinical+medicine%22">0302 clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Valve+replacement%22">Valve replacement</searchLink><br /><searchLink fieldCode="DE" term="%22law%22">law</searchLink><br /><searchLink fieldCode="DE" term="%22Monitoring%2C+Intraoperative%22">Monitoring, Intraoperative</searchLink><br /><searchLink fieldCode="DE" term="%22medicine%22">medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Humans%22">Humans</searchLink><br /><searchLink fieldCode="DE" term="%22Prospective+Studies%22">Prospective Studies</searchLink><br /><searchLink fieldCode="DE" term="%22030212+general+%26+internal+medicine%22">030212 general & internal medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Prospective+cohort+study%22">Prospective cohort study</searchLink><br /><searchLink fieldCode="DE" term="%22Aged%22">Aged</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink><br /><searchLink fieldCode="DE" term="%22Aged%2C+80+and+over%22">Aged, 80 and over</searchLink><br /><searchLink fieldCode="DE" term="%22business%2Eindustry%22">business.industry</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+Selection%22">Patient Selection</searchLink><br /><searchLink fieldCode="DE" term="%22Significant+difference%22">Significant difference</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+cohort+study%22">Retrospective cohort study</searchLink><br /><searchLink fieldCode="DE" term="%22University+hospital%22">University hospital</searchLink><br /><searchLink fieldCode="DE" term="%22Intensive+care+unit%22">Intensive care unit</searchLink><br /><searchLink fieldCode="DE" term="%22Surgery%22">Surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Femoral+Artery%22">Femoral Artery</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+Outcome%22">Treatment Outcome</searchLink><br /><searchLink fieldCode="DE" term="%22Anesthesiology+and+Pain+Medicine%22">Anesthesiology and Pain Medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Anesthesia%22">Anesthesia</searchLink><br /><searchLink fieldCode="DE" term="%22Female%22">Female</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiology+and+Cardiovascular+Medicine%22">Cardiology and Cardiovascular Medicine</searchLink><br /><searchLink fieldCode="DE" term="%22business%22">business</searchLink><br /><searchLink fieldCode="DE" term="%22Resource+utilization%22">Resource utilization</searchLink> ) Array ( [Name] => Abstract [Label] => Description [Group] => Ab [Data] => Objective The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. Design Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. Setting Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. Participants Patients selected for TF-TAVR. Interventions Patients were divided into those who underwent MAC and those who underwent GA. Measurements and Main Results The study comprised 104 consecutive patients (55% male, mean age 83 years) who underwent TF-TAVR under MAC (n = 60) or GA (n = 37) from 2014 to 2015. Seven patients were converted from MAC to GA and were omitted from analysis. There was no statistically significant difference between 30-day mortality and complications between the 2 groups. The MAC group had a significantly shorter median intensive care unit length of stay (48 h v 74 h, p = 0.0002). The MAC group also demonstrated reduced procedural time (45.5 min v 62 min, p = 0.003); operating room time (111 min v 153 min, p = Conclusions Patient selection for TF-TAVR with MAC can be formalized and implemented successfully. MAC allows for the minimizing of patient exposure to unnecessary interventions and improving resource utilization in suitable TAVR patients. Selection requires a multidisciplinary clinical decision-making process. MAC demonstrates good outcomes compared with GA, yet it is important to have a cardiac anesthesiologist present in the event of emergency conversion to GA. ) Array ( [Name] => ISSN [Label] => ISSN [Group] => ISSN [Data] => 1053-0770 ) Array ( [Name] => URL [Label] => Access URL [Group] => URL [Data] => <link linkTarget="URL" linkTerm="https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dc0602f0a42f25e76ba08457f7fb24b0" linkWindow="_blank">https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dc0602f0a42f25e76ba08457f7fb24b0</link><br /><link linkTarget="URL" linkTerm="https://doi.org/10.1053/j.jvca.2017.04.005" linkWindow="_blank">https://doi.org/10.1053/j.jvca.2017.04.005</link> ) Array ( [Name] => Copyright [Label] => Rights [Group] => Cpyrght [Data] => CLOSED ) Array ( [Name] => AN [Label] => Accession Number [Group] => ID [Data] => edsair.doi.dedup.....dc0602f0a42f25e76ba08457f7fb24b0 )
RecordInfo	Array ( [BibEntity] => Array ( [Languages] => Array ( [0] => Array ( [Text] => Undetermined ) ) [PhysicalDescription] => Array ( [Pagination] => Array ( [PageCount] => 6 [StartPage] => 2049 ) ) [Subjects] => Array ( [0] => Array ( [SubjectFull] => Male [Type] => general ) [1] => Array ( [SubjectFull] => medicine.medical_specialty [Type] => general ) [2] => Array ( [SubjectFull] => Transcatheter aortic [Type] => general ) [3] => Array ( [SubjectFull] => medicine.medical_treatment [Type] => general ) [4] => Array ( [SubjectFull] => Anesthesia, General [Type] => general ) [5] => Array ( [SubjectFull] => 030204 cardiovascular system & hematology [Type] => general ) [6] => Array ( [SubjectFull] => law.invention [Type] => general ) [7] => Array ( [SubjectFull] => Transcatheter Aortic Valve Replacement [Type] => general ) [8] => Array ( [SubjectFull] => 03 medical and health sciences [Type] => general ) [9] => Array ( [SubjectFull] => 0302 clinical medicine [Type] => general ) [10] => Array ( [SubjectFull] => Valve replacement [Type] => general ) [11] => Array ( [SubjectFull] => law [Type] => general ) [12] => Array ( [SubjectFull] => Monitoring, Intraoperative [Type] => general ) [13] => Array ( [SubjectFull] => medicine [Type] => general ) [14] => Array ( [SubjectFull] => Humans [Type] => general ) [15] => Array ( [SubjectFull] => Prospective Studies [Type] => general ) [16] => Array ( [SubjectFull] => 030212 general & internal medicine [Type] => general ) [17] => Array ( [SubjectFull] => Prospective cohort study [Type] => general ) [18] => Array ( [SubjectFull] => Aged [Type] => general ) [19] => Array ( [SubjectFull] => Retrospective Studies [Type] => general ) [20] => Array ( [SubjectFull] => Aged, 80 and over [Type] => general ) [21] => Array ( [SubjectFull] => business.industry [Type] => general ) [22] => Array ( [SubjectFull] => Patient Selection [Type] => general ) [23] => Array ( [SubjectFull] => Significant difference [Type] => general ) [24] => Array ( [SubjectFull] => Retrospective cohort study [Type] => general ) [25] => Array ( [SubjectFull] => University hospital [Type] => general ) [26] => Array ( [SubjectFull] => Intensive care unit [Type] => general ) [27] => Array ( [SubjectFull] => Surgery [Type] => general ) [28] => Array ( [SubjectFull] => Femoral Artery [Type] => general ) [29] => Array ( [SubjectFull] => Treatment Outcome [Type] => general ) [30] => Array ( [SubjectFull] => Anesthesiology and Pain Medicine [Type] => general ) [31] => Array ( [SubjectFull] => Anesthesia [Type] => general ) [32] => Array ( [SubjectFull] => Female [Type] => general ) [33] => Array ( [SubjectFull] => Cardiology and Cardiovascular Medicine [Type] => general ) [34] => Array ( [SubjectFull] => business [Type] => general ) [35] => Array ( [SubjectFull] => Resource utilization [Type] => general ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => Patient Selection and Outcomes of Transfemoral Transcatheter Aortic Valve Replacement Performed with Monitored Anesthesia Care Versus General Anesthesia [Type] => main ) ) ) [BibRelationships] => Array ( [HasContributorRelationships] => Array ( [0] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Michael Welljams-Dorof ) ) ) [1] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => John Cagino ) ) ) [2] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Constantine M. Poulos ) ) ) [3] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Nathapong Arunakul ) ) ) [4] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Kevin Roberts ) ) ) [5] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Christopher Ursillo ) ) ) [6] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Augustine Delago ) ) ) [7] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Paul J. Feustel ) ) ) [8] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Natalie Bruno ) ) ) [9] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Mikhail Torosoff ) ) ) [10] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Sridhar R. Musuku ) ) ) [11] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Saroj Pani ) ) ) [12] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Asim Raja ) ) ) ) [IsPartOfRelationships] => Array ( [0] => Array ( [BibEntity] => Array ( [Dates] => Array ( [0] => Array ( [D] => 01 [M] => 12 [Type] => published [Y] => 2017 ) ) [Identifiers] => Array ( [0] => Array ( [Type] => issn-print [Value] => 10530770 ) [1] => Array ( [Type] => issn-locals [Value] => edsair ) ) [Numbering] => Array ( [0] => Array ( [Type] => volume [Value] => 31 ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => Journal of Cardiothoracic and Vascular Anesthesia [Type] => main ) ) ) ) ) ) )
IllustrationInfo