Patient Quality of Recovery After TAVR With Different Sedation Regimens

Primary Outcome Measures

1. Quality of Recovery on Postoperative Day 1 Measured by QoR-15 Survey
   The primary outcome of the study will be the quality of recovery, as measured by the Quality of Recovery-15 (QoR-15) score. A baseline QoR-15 survey will be taken before or on the day of the procedure, and the resulting aggregate score will be compared to the score from the QoR-15 survey completed on post-operative day 1 (POD 1). The QoR-15 survey is 15-item questionnaire which has a scale of 0-10 pertaining to a patient's comfort, support system, pain, well-being, and ability to carry out daily activities. For questions 1-10, number "0" indicates none of the time and number "10" indicates all of the time. For questions 11-15, number "0" indicates all of the time and number "10" indicates none of the time. A higher overall score indicates a better outcome (i.e. better quality of recovery) and a lower score indicates a worse outcome (i.e. poorer quality of recovery).

Secondary Outcome Measures

1. Heart Rate Change
   Change in heart rate from baseline to nadir intraoperatively and at Post-Anesthesia Care Unit (PACU) admission.
2. Length of Stay
   PACU length of stay and total hospital length of stay
3. Patient Satisfaction with Anesthesia Measured by 5-Point Likert Scale
   Patient-reported satisfaction with anesthesia measured using a 5-point Likert scale. Patients will respond to this statement: The anesthesia care I received during my transcatheter aortic valve replacement (TAVR) procedure met my expectations (5 = Strongly Agree; 1 = Strongly Disagree).
4. Pain Scores Measured by Visual Analog Scale (VAS)
   Pain severity measured using the Visual Analog Scale (VAS).
5. Quality of Recovery on Postoperative Day 7 Measured by QoR-15 Survey
   Quality of recovery measured using the Quality of Recover-15 (QoR-15) questionnaire on postoperative day 7. The QoR-15 survey is 15-item questionnaire which has a scale of 0-10 pertaining to a patient's comfort, support system, pain, well-being, and ability to carry out daily activities. For questions 1-10, number "0" indicates none of the time and number "10" indicates all of the time. For questions 11-15, number "0" indicates all of the time and number "10" indicates none of the time. A higher overall score indicates a better outcome (i.e. better quality of recovery) and a lower score indicates a worse outcome (i.e. poorer quality of recovery).
6. Cardiologist Operating Conditions Rating
   Cardiologist-rated procedural conditions assessed using a 5-point Likert scale. The cardiologist will report their satisfaction with the TAVR patient's surgical condition (5 = Very Satisfied; 1 = Very Dissatisfied)
7. 30-Day Readmission Rates
   Hospital readmission rates within 30 days following TAVR
8. Incidence of Hypotension Requiring Medical Intervention
   Incidence of hypotension (defined as ≥20% reduction from baseline) requiring medical intervention.
9. Fluid Administration From Start of Procedure Through PACU Discharge
   Total intravenous fluid volume administered.
10. Incidence of Intraoperative Bradycardia
    Incidence of heart rate \< 60 beats per minute.
11. Surgical Bleeding
    Incidence of clinically significant surgical bleeding.
12. Conversion to General Anesthesia
    Need for conversion from planned sedation to general anesthesia.
13. Postoperative Pacemaker Placement
    Need for new permanent pacemaker implantation after TAVR.
14. Postoperative Delirium Measured by 4AT Assessment
    Incidence of postoperative delirium assessed using the 4AT screening tool.