Deep Sedation versus General Anaesthesia for Transcatheter Mitral Valve Repair: An Individual-Patient Data Meta-analysis of Observational Studies.

Aims To compare general anaesthesia (GA) and deep sedation (DS) with regard to safety and length of intensive care unit (ICU) stay in patients undergoing percutaneous edge-to-edge mitral valve repair (PMVR). Methods and results Four studies comparing GA and DS in patients undergoing PMVR were included in an individual patient data meta-analysis. Data were pooled after multiple imputation. The composite safety endpoint of all-cause death, stroke, pneumonia, or major to life-threatening bleeding occurred in 87 of 626 (13.9%) patients with no difference between patients treated with DS as compared to GA (56 and 31 events in 420 and 206 patients, respectively). In this regard, the odds ratio was 1.27 (95% confidence interval, 0.78 to 2.09; p = 0.338) and 1.26 (95% confidence interval, 0.49 to 3.22; p = 0.496) following the one-stage and two-stage approach, respectively. Length of ICU stay was longer after GA as compared to DS (ratio of days 3.08, 95% confidence interval, 2.18 to 4.36, p l 0.001 and 2.88, 95% confidence interval, 1.45 to 5.73, p = 0.016 following the one-stage and two-stage approach, respectively). Conclusions Both, DS and GA might offer a similar safety profile. However, ICU stay seems to be shorter after DS.