• Sridhar R Musuku, Christopher A Di Capua, Isha Doshi, Divya Cherukupalli, Youjung Byun, and Alexander D Shapeton.
• Department of Anesthesiology and Perioperative Medicine, Albany Medical Center, Albany, NY. Electronic address: musukus@mail.amc.edu.
• J. Cardiothorac. Vasc. Anesth. 2021 Jun 1; 35 (6): 1760-1768.

ObjectiveCompare general anesthesia with a supraglottic airway versus monitored anesthesia care for transfemoral transcatheter aortic valve replacement (TF-TAVR) in patients with aortic stenosis. The authors hypothesized that the supraglottic airway group would have similar operating room and procedure times, postanesthesia care unit (PACU) and hospital stays, and similar rates of intraprocedural and postprocedural complications compared with the monitored anesthesia care group.Study DesignRetrospective chart review with 1:1 propensity score matching of supraglottic airway to monitored anesthesia care patients.SettingTertiary care academic medical center.ParticipantsTF-TAVR patients between 2017 and 2019.InterventionsSupraglottic airway or monitored anesthesia care.Measurements And Main ResultsOne hundred forty-eight supraglottic airway patients were matched with 148 monitored anesthesia care patients. Monitored anesthesia care patients had slightly shorter operating room (p < 0.001) and procedure times (p = 0.015). No difference was observed in hospital length of stay (p = 0.34). Fewer patients in the supraglottic airway group required a PACU stay >2 hours (p < 0.001). Use of intraprocedural vasopressors (p < 0.001) and fentanyl dosage (p < 0.001) was higher in the supraglottic airway group. No differences were observed in postoperative complications or procedural success rates.ConclusionsIn this, the first study to compare these 2 modalities, supraglottic airway use was demonstrated to be a safe, feasible alternative to monitored anesthesia care during TF-TAVR and did not increase organ-specific morbidity, 30-day mortality, hospital length of stay, or PACU length of stay. Even though supraglottic airway was associated with slight increases in procedure and operating room times, these were not clinically significant.Copyright © 2020 Elsevier Inc. All rights reserved.

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