Redo Transcatheter Valve in Valve Versus Redo Surgical Aortic Valve Replacement, from National Inpatient Sample
Presenter
Salman Zahid, Rochester General Hospital, Rochester, NY
Salman Zahid1, Muhammad Z Khan, MD2, Muhammad U Khan3 and Sudarshan Balla, MD2, (1)Rochester General Hospital, Rochester, NY, (2)West Virginia University School Of Medicine, Morgantown, WV, (3)The West Virginia University School of Medicine, Morgantown, WV
Keywords: TAVI/TAVR/Aortic Valve
Background
Data on outcomes of valve in valve transcatheter aortic valve replacement (ViV TAVR) compared to redo surgical aortic valve replacement(SAVR) for degenerated bioprosthetic valves remains limited.
Methods
The National Inpatient Sample (NIS) database from 2015 to 2018 was queried to study the mortality, resource utilization, comorbidity burden, and clinical outcomes of hospitalizations with ViV TAVR and redo SAVR procedures for degenerated bioprosthetic valve.
Results
A total of 5,700 were included in the analysis. 2,970 patients underwent redo SAVR and 2,730 underwent ViV TAVR. ViV TAVR group was older, with higher proportion of females, and increased prevalence of congestive heart failure, coronary artery disease and renal failure. Peripheral vascular disease was more prevalent in the redo SAVR group. Adjusted in hospital mortality was significantly higher in redo SAVR compared to ViV TAVR (5.2% vs. <0.9% p<0.01 ). Blood transfusion (26.2% vs 9.7%, p<0.01) and acute kidney injury (22.2% vs 6.3%, p<0.01) were more common in redo SAVR, whereas permanent pacemaker implantation (10.3% vs 9.9%, p=0.74) and vascular complications (5.6% vs <0.9%, p<0.01) were more common in ViV TAVR. More patients were discharged to home after ViV TAVR (75% vs 30.6%, p<0.01).
Conclusions
ViV TAVR is associated with lower mortality, peri-procedural morbidity and resource utilization compared to redo SAVR. Vascular complications were higher in the ViV TAVR group compared to SAVR group.
