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Date Published: 21/04/2026
Abstract Views: 0
DOI: 10.47972/vjcts.v55i.1716
Issue
Vol. 55
Section
Research Article
How to Cite
Nguyen, T. B., Nguyen, T. T., Dang, T. T. V., Tran, T. T. H., Tran, T. N. B., Ho, T. N. M., Le, T. T., Tran, T. A. H., Nguyen, T. N. H., & Nguyen, T. H. N. (2026). Anesthesia strategies for transcatheter aortic valve implantation by transfemoral access route: a narative review. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 55. https://doi.org/10.47972/vjcts.v55i.1716

Anesthesia strategies for transcatheter aortic valve implantation by transfemoral access route: a narative review

Tat Binh Nguyen1,2, , Trung Thanh Nguyen, Thi Thuy Van Dang, Thi Thanh Hang Tran, Thi Ngoc Bich Tran, Thi Ngoc Mai Ho, Thi Tam Le, Thi Anh Hien Tran, Thi Nhu Ha Nguyen, Thi Hoai Nam Nguyen
1 Department of Anesthesiology and Pain Medicine, Vinmec Central Park
2 Colleage of Health Sciences, Vinuni

Main Article Content

Abstract

Objective: To summarize the clinical evidence regarding anesthetic techniques for transfemoral transcatheter aortic valve implantation (TF-TAVI) and to propose a practical decision-making algorithm.


Methods: A comprehensive literature search was conducted across PubMed and Cochrane databases using keywords including "TAVI," "transfemoral," "local anesthesia," "conscious sedation," "regional anesthesia," and "nerve block." Recent and clinically relevant studies were selected for qualitative synthesis.


Results: Based on the literature review, local anesthesia combined with conscious sedation (CS/LA) has been demonstrated to be non-inferior to general anesthesia regarding short-term clinical outcomes while maintaining a comparable safety profile during long-term follow-up. Meta-analyses and registry data suggest modest but consistent and feasible early benefits. Therefore, LA/CS should be considered the default strategy for TF-TAVI. Regional anesthesia (RA) serves as an effective adjunct: ilioinguinal/iliohypogastric blocks (II-IHB) are preferred, while fascia iliaca block (FIB) or transversus abdominis plane block (TAPB) may be considered for severe lower abdominal wall pain or to achieve prolonged analgesia. Spinal anesthesia (SA) should only be reserved for highly selected cases, requiring precise dose titration and rigorous hemodynamic monitoring.


Conclusions: CS/LA remains the gold standard for TF-TAVI. Adjunctive RA enhances the quality of anesthesia and reduces systemic anesthetic consumption. SA should be utilized selectively. Further multicenter randomized controlled trials are warranted to standardize anesthetic algorithms for TF-TAVI.

Keywords

Transcatheter aortic valve implantation, local anaesthesia, conscious sedation, regional anaesthesia, ilioinguinal–iliohypogastric block, fascia iliaca block, transversus abdominis plane block, spinal anaesthesia

Article Details

References

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