Home›Cardiology› General anesthesia increases in-hospital mortality risk (RR 1.99) and pneumonia incidence (RR 2.39) in TAVI procedures
General anesthesia increases in-hospital mortality risk (RR 1.99) and pneumonia incidence (RR 2.39) in TAVI proceduresGeneral anesthesia may increase risks for patients with aortic stenosis
Frontiers in MedicinePublished July 17, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Note that general anesthesia is associated with higher mortality, pneumonia risk, and longer procedure times in TAVI.
This meta-analysis evaluates the clinical outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) who received general anesthesia (GA) compared to non-general anesthesia groups, which included regional, local, and monitored anesthesia. The study pooled data from 23,848 patients to assess in-hospital mortality, postoperative pneumonia, and procedure time.
The analysis indicates that the GA group experienced a significantly higher risk of in-hospital mortality (RR = 1.99; 95%CI, 1.19–3.30, P = 0.008) compared to non-GA groups. Additionally, patients receiving general anesthesia showed a higher incidence of postoperative pneumonia (RR = 2.39; 95%CI, 1.43–4.00, P = 0.0009). Procedure times were also significantly longer in the GA group (MD = 20.22; 95%CI, 15.37–25.07, P < 0.001).
A notable limitation is that the non-GA comparison group is heterogeneous, encompassing various types of anesthesia such as regional, local, and deep sedation. While these results suggest a correlation between general anesthesia and poorer outcomes in TAVI patients, the specific clinical implications for anesthetic choice should be weighed against individual patient needs.
How this fits prior evidence
This meta-analysis addresses gaps in understanding procedural risks during transcatheter aortic valve implantation. While prior evidence notes that early intervention reduces MACE and certain techniques like cusp-overlap reduce mortality, this study specifically highlights the impact of anesthesia type on outcomes. It provides specific risk metrics for in-hospital mortality (RR = 1.99) and pneumonia (RR = 2.39) associated with general anesthesia compared to non-GA methods.
When a patient needs a transcatheter aortic valve implantation (TAVI) to treat a narrowed heart valve, the type of anesthesia used can have a big impact. A large review of data from over 23,000 patients looked at how general anesthesia compares to other methods like local or regional anesthesia and deep sedation.
The findings show that patients who received general anesthesia faced a higher risk of dying in the hospital compared to those who received other types of care. The study also found these patients were more likely to develop pneumonia after their surgery and spent more time in the operating room.
It is important to note that the comparison group included several different types of non-general anesthesia, such as local and regional options. Because this was a meta-analysis, it shows an association between general anesthesia and these risks rather than a direct cause. Patients should talk with their doctors about which sedation method is safest for their specific needs.
What this means for you:
General anesthesia may increase the risk of death and pneumonia in patients undergoing TAVI procedures.
Common questions
Is general anesthesia riskier for TAVI patients?
The data shows that patients who received general anesthesia had a higher risk of in-hospital mortality compared to those who received non-general anesthesia. Specifically, the risk was nearly double for those under general anesthesia. You should discuss these specific risks with your medical team before choosing an anesthesia method.
Can general anesthesia cause pneumonia after heart surgery?
Yes, the study found that patients who received general anesthesia had a higher incidence of postoperative pneumonia compared to those in the non-general anesthesia groups. This means they were more likely to develop a lung infection following their procedure.
How does procedure time differ between types of anesthesia?
Patients who received general anesthesia had significantly longer procedure times than those who received other forms of sedation or local anesthesia. The difference was over 20 minutes on average, which may impact the overall surgical experience.
ObjectiveThe optimal mode of anesthesia for patients undergoing transcatheter aortic valve implantation (TAVI) surgery has been controversial recently, especially with the popularization of TAVI in young and low-risk patients and reduced dependence on transesophageal echocardiography (TEE). Beyond general anesthesia (GA), there are more than one type of anesthetic methods such as regional anesthesia (RA), local anesthesia (LA), monitored anesthesia care (MAC), deep sedation (DS), conscious sedation (CS) et al. used on TAVI. The aim of this systematic review and meta-analysis was to evaluate the effects of general anesthesia on the prognosis of patients undergoing TAVI.MethodsThe Cochrane Library, PubMed, Embase, and Medline databases were searched from their inception to May 2025. Literature was selected according to the inclusion and exclusion criteria, and the meta-analysis was completed using RevMan 5.3.ResultsA total of eligible 38 literatures were enrolled, including 23,848 patients. The results of the meta-analysis showed that compared with the non-GA groups, the in-hospital mortality (RR = 1.99, 95%CI, 1.19–3.30, P = 0.008), incidence of postoperative pneumonia (RR = 2.39, 95%CI, 1.43–4.00, P = 0.0009), procedure time (MD = 20.22, 95%CI, 15.37–25.07, P
