Response to Prof. Dr. med. Gunther Wiesner, Prof. Dr. med. Peter Tassani-Prell, and Dr. Patrick Mayr
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We thank the authors for their thoughtful discussion of our analysis.
First, as stated in the limitation section of the manuscript, we agree that the difference of intensive care unit length of stay following deep sedation (DS) could theoretically be explained by differing post-interventional therapeutic strategies and clinical infrastructure as well as growing experience . However, with the exception of mode of anaesthesia, individual decision makers in both hospitals were the same and thus treatment strategies as well as post-interventional management did likely not differ significantly between the two centres. We thus do not believe that the site of centre is an important influencing factor.
Second, we agree that the observation of non-differing length of hospital stay is of importance. However, as already discussed in the manuscript, this can be most likely explained by non-procedural post-interventional related factors, such as decongestion or mobilisation. Length of...
KeywordsAortic Valve Replacement Catheter Ablation Deep Sedation Transcatheter Aortic Valve Replacement Left Atrial Appendage
- 1.de Waha S, Seeburger J, Ender J, Desch S, Eitel I, Reinhardt A, Poss J, Fuernau G, Noack T, Merk DR, Schuler G, Sievers HH, Mohr FW, Thiele H (2016) Deep sedation versus general anesthesia in percutaneous edge-to-edge mitral valve reconstruction using the MitraClip system. Clin Res Cardiol 105(6):535–543. doi: 10.1007/s00392-015-0951-z CrossRefPubMedGoogle Scholar
- 3.Bainbridge D, Martin J, Arango M, Cheng D, Evidence-based Peri-operative Clinical Outcomes Research G (2012) Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet 380(9847):1075–1081. doi: 10.1016/S0140-6736(12)60990-8 CrossRefPubMedGoogle Scholar
- 4.Kristensen SD, Knuuti J, Saraste A, Anker S, Botker HE, Hert SD, Ford I, Gonzalez-Juanatey JR, Gorenek B, Heyndrickx GR, Hoeft A, Huber K, Iung B, Kjeldsen KP, Longrois D, Luscher TF, Pierard L, Pocock S, Price S, Roffi M, Sirnes PA, Sousa-Uva M, Voudris V, Funck-Brentano C, Authors/Task Force M (2014) 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 35(35):2383–2431. doi: 10.1093/eurheartj/ehu282 CrossRefPubMedGoogle Scholar
- 5.Ledwoch J, Matic P, Franke J, Gafoor S, Bertog S, Reinartz M, Vaskelyte L, Hofmann I, Sievert H (2015) Transcatheter mitral valve repair with the MitraClip can be performed without general anesthesia and without conscious sedation. Clin Res Cardiol. doi: 10.1007/s00392-015-0918-0 PubMedGoogle Scholar
- 6.Teufel T, Steinberg DH, Wunderlich N, Doss M, Fichtlscherer S, Ledwoch J, Herholz T, Hofmann I, Sievert H (2012) Percutaneous mitral valve repair with the MitraClip(R) system under deep sedation and local anaesthesia. Eurointervention 8(5):587–590. doi: 10.4244/EIJV8I5A90 CrossRefPubMedGoogle Scholar
- 7.Rassaf T, Balzer J, Zeus T, Rammos C, Shayganfar S, Hall SV, Wagstaff R, Kelm M (2014) Safety and efficacy of deep sedation as compared to general anaesthesia in percutaneous mitral valve repair using the MitraClip system. Catheter Cardiovas Interv 84(4):E38–E42. doi: 10.1002/ccd.25570 CrossRefGoogle Scholar
- 8.Frohlich GM, Lansky AJ, Webb J, Roffi M, Toggweiler S, Reinthaler M, Wang D, Hutchinson N, Wendler O, Hildick-Smith D, Meier P (2014) Local versus general anesthesia for transcatheter aortic valve implantation (TAVR)—systematic review and meta-analysis. BMC Med 12:41. doi: 10.1186/1741-7015-12-41 CrossRefPubMedPubMedCentralGoogle Scholar