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Prolonged transesophageal echocardiography during percutaneous closure of the left atrial appendage without general anesthesia: the utility of the Janus mask.
CONCLUSION: Deep sedation with noninvasive ventilation may be a reasonable and safe alternative to general endotracheal anesthesia in patients requiring prolonged TEE for noninvasive cardiac procedures, including LAA closure. PMID: 27117991 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - April 25, 2016 Category: Anesthesiology Authors: Zangrillo A, Mazzone P, Votta CD, Villari N, Della Bella P, Monaco F Tags: Can J Anaesth Source Type: research

Left atrial appendage closure without general anaesthesia
Left atrial appendage closure is an important interventional procedure to prevent stroke in patients with permanent atrial fibrillation and contraindication to anticoagulants. Because it requires the patient not to move and the performance of a continuous and prolonged transoesophageal echocardiography (TEE), such procedure is usually performed under general anaesthesia. The risk of general anaesthesia in the elderly is associated with difficult airway control, malignant hyperthermia, residual neuromuscular block, high risk of postoperative pulmonary complications, and the risk of accelerated cognitive decline.
Source: Journal of Cardiothoracic and Vascular Anesthesia - April 30, 2016 Category: Anesthesiology Authors: F Monaco, Evgeny Fominskiy, C D Votta, N Villari, R Capucci, JC Lopez-Delgado, V Camarda, M Baiardo Redaelli, A Oriani, A Zangrillo Source Type: research