Document Type
Article
Publication Date
10-1-2022
Abstract
Background: Heart failure (HF) is a complex clinical syndrome with symptoms and signs that result from any structural or functional impairment of ventricular filling or ejection of blood. Limited data is available regarding the in-hospital outcomes of TAVR compared to SAVR in the octogenarian population with HF.
Methods: The National Inpatient Sample (NIS) database was used to compare TAVR versus SAVR among octogenarians with HF. The primary outcome was in-hospital mortality. The secondary outcome included acute kidney injury (AKI), cerebrovascular accident (CVA), post-procedural stroke, major bleeding, blood transfusions, sudden cardiac arrest (SCA), cardiogenic shock (CS), and mechanical circulatory support (MCS).
Results: A total of 74,995 octogenarian patients with HF (TAVR-HF n = 64,890 (86.5%); SAVR n = 10,105 (13.5%)) were included. The median age of patients in TAVR-HF and SAVR-HF was 86 (83-89) and 82 (81-84) respectively. TAVR-HF had lower percentage in-hospital mortality (1.8% vs. 6.9%;p < 0.001), CVA (2.5% vs. 3.6%; p = 0.009), SCA (9.9% vs. 20.2%; p < 0.001), AKI (17.4% vs. 40.8%); p < 0.001), major transfusion (26.4% vs 67.3%; p < 0.001), CS (1.8% vs 9.8%; p < 0.001), and MCS (0.8% vs 7.3%; p < 0.001) when compared to SAVR-HF. Additionally, post-procedural stroke and major bleeding showed no significant difference. The median unmatched total charges for TAVR-HF and SAVR-HF were 194,561$ and 246,100$ respectively.
Conclusion: In this nationwide observational analysis, TAVR is associated with an improved safety profile for octogenarians with heart failure (both preserved and reduced ejection fraction) compared to SAVR.
Recommended Citation
Sattar, Yasar; Song, David; Almas, Talal; Zghouzi, Mohamed; Talib, Usama; Suleiman, Abdul-Rahman M; Ahmad, Bachar; Arshad, Junaid; Ullah, Waqas; Zia Khan, Muhammad; Bianco, Christopher M; Bagur, Rodrigo; Rashid, Muhammad; Mamas, Mamas A; and Alraies, M Chadi, "Cardiovascular Outcomes and Trends of Transcatheter vs. Surgical Aortic Valve Replacement Among Octogenarians With Heart Failure: A Propensity Matched National Cohort Analysis" (2022). Division of Cardiology Faculty Papers. Paper 106.
https://jdc.jefferson.edu/cardiologyfp/106
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
PubMed ID
36161232
Comments
This article is the author’s final published version in IJC Heart and Vasculature, Volume 42, October 2022, Article number 101119.
The published version is available at https://doi.org/10.1016/j.ijcha.2022.101119. Copyright © Sattar et al.