Optimizing anesthesia to enhance transcatheter aortic valve replacement outcomes

Abstract Since its introduction in 2002, transcatheter aortic valve replacement (TAVR) has gained rapid worldwide adoption, significantly increasing the survival rates of high-risk surgical patients. As key members of the multidisciplinary TAVR team, anesthesiologists play a crucial role in perioperative care. Initially, anesthesiologists administered general endotracheal anesthesia, maintained hemodynamic stability, monitored cardiac function with transesophageal echocardiography, and managed adverse events. Improvements in techniques and valve design have expanded TAVR indications, enabling minimally invasive procedures. As a result, anesthesia practices have shifted from general anesthesia to monitored anesthesia care or local anesthesia. Today, anesthesia efforts focus on refining perioperative strategies to improve patient comfort while reducing complications, length of hospital stay, costs, and mortality. These developments highlight the essential role of anesthesiologists in optimizing TAVR outcomes.