Monitored Anesthesia Care vs. General Anesthesia for Transcatheter Aortic Valve Replacement

A Randomized Controlled Trial Comparing Monitored Anesthesia Care Versus General Anesthesia With Transesophgeal Echocardiography for Transcatheter Aortic Valve Replacement

This study is being done to evaluate the impact that monitored anesthetic care (MAC) versus general endotracheal anesthesia (GETA) has on hospital length of stay, rate of ICU admission, and procedural mortality for patients undergoing Transcatheter Aortic Valve Replacement (TAVR). Also, the investigators hope to determine if the use of Transesophageal Echocardiography (TEE) during GETA impacts device success. Adult patients undergoing transfemoral approach TAVR for aortic valve stenosis may be eligible candidates for this study.

Inclusion Criteria:

• Adult patients ≥ 18 years old
• Adult patients undergoing transfemoral approach TAVR for aortic valve stenosis
• Adult patients who are medically eligible to receive both anesthetics (GA and MAC)

Exclusion Criteria:

• Inability to speak English
• Body Mass Index (BMI) > 37 kg/m2
• History of difficult airway requiring fiberoptic intubation
• Inability to lie flat
• Women who are pregnant
• Patients who have contraindications to either anesthetic, such as an allergy or history of malignant hyperthermia, will also be excluded from the study.
• Inability or unwillingness of subject to give informed consent based on any reason
• Patients with any of the following absolute contraindications to TEE:
• Perforated Viscus
• Esophageal Stricture
• Esophageal Tumor
• Esophageal Perforation
• Esophageal Diverticulum
• Active upper GI Bleed