Dexmedetomidine Is an Equal Cost Alternative to Propofol in Transcatheter Aortic Valve Replacement, With Equivalent In-Hospital and 30-Day Outcomes

Anthony P. Kronfli, Erik Lehman, Kentaro Yamane, S. Michael Roberts, Theodore J. Cios

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: Transcatheter aortic valve replacement (TAVR) with monitored anesthesia care (MAC) is well-tolerated and is growing in popularity. Differences in outcomes based on anesthetic agent choice with MAC has received less attention. The authors sought to determine whether differences in outcomes and cost exist based on whether patients receive dexmedetomidine or propofol when undergoing TAVR with MAC. Design: Retrospective cohort study. Setting: The Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Participants: The study comprised 161 patients who underwent TAVR with MAC between May 2014 and March 2019. Interventions: None. Measurements and Main Results: A propofol-only (n = 58) group and dexmedetomidine-only (n = 103) group were identified. No differences in in-hospital mortality or complication rate were identified when evaluating for stroke, transfusion, new arrhythmia, cardiac arrest, or bleeding and vascular complications (p > 0.05, all). Thirty-day outcomes were also equivalent, with no differences in mortality, stroke, vascular complication, new arrhythmia, or myocardial infarction (p > 0.05, all). The average amount of epinephrine, norepinephrine, or phenylephrine used intraoperatively was not significantly different. Overall median hospitalization costs were equivalent ($57,554.31 with dexmedetomidine v $58,538.08 with propofol, p = 0.97). Conclusions: There were no significant differences in in-hospital outcomes, 30-day outcomes, or total cost of the patient's hospitalization, based on the use of dexmedetomidine versus propofol in patients undergoing TAVR.

Original languageEnglish (US)
Pages (from-to)439-445
Number of pages7
JournalJournal of cardiothoracic and vascular anesthesia
Volume35
Issue number2
DOIs
StateAccepted/In press - 2020

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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