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- W4380716281 abstract "Introduction: Transcatheter aortic valve replacement (TAVR) is rapidly becoming commonplace for hemodynamically significant aortic stenosis (AS). Heart failure (HF) is a common comorbidity in aortic stenosis patients. Prolonged elevated left ventricular pressures result in progressive left ventricular hypertrophy and remodeling which in turn predisposes to the HF. Since many who undergo TAVR for AS could have HF, we aimed to assess periprocedural outcomes in this population. Methods: We utilized the National Inpatient Sample from 2016-2019 to identify 217,575 hospitalized adults who underwent TAVR for AS. These hospitalizations were further stratified based on the presence of HF. A multivariate regression model was used to adjust for confounders and analyze the variables. Results: Of those who underwent TAVR for AS, 146,770 (67.4%) had HF. Those with HF had a higher proportion of males (47.3% vs 41.6%; p<0.001). Figure 1 shows the Forrest plot for multivariate analysis of peri-procedural complications when adjusted for patient demographics, comorbidities, and hospital characteristics. When adjusted similarly, patients with HF who underwent TAVR had longer length of stay (LOS) by 0.89 days (p<0.001) and had additional hospital costs (HC) of $13,297 (p<0.001). Conclusions: Patients undergoing TAVR with co-existing HF had significantly worse outcomes in terms of LOS, HC, atrial flutter, AKI, sepsis, pneumonia, and endotracheal intubation. Patients with severe AS may have altered myocardial contractility and periprocedural hemodynamic shifts may be poorly tolerated due to structural and functional impairments that persist even after correction of afterload. Despite the risk of periprocedural outcomes, the benefit of ventricular unloading particularly in those with preserved or mildly reduced ejection fraction should not be overlooked." @default.
- W4380716281 created "2023-06-15" @default.
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- W4380716281 date "2022-11-08" @default.
- W4380716281 modified "2023-09-23" @default.
- W4380716281 title "Abstract 15680: Impact of Heart Failure on Peri-Procedural Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement" @default.
- W4380716281 doi "https://doi.org/10.1161/circ.146.suppl_1.15680" @default.
- W4380716281 hasPublicationYear "2022" @default.
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