SHORT-TERM OUTCOMES AFTER TAVR IN PATIENTS WITH LOCAL AND ADVANCED MALIGNANCY: AN ANALYSIS OF THE NATIONAL INPATIENT SAMPLE 2016-2017.
Presenter
Juan Del Cid Fratti MD MS, MD MSc, The University of Washington, Peoria, IL
Juan Del Cid Fratti MD MS, MD MSc1, Miguel Salazar, MD2, Sriviji Senthil3, Ezequiel Munoz, MD4 and Sudhir Mungee, M.D., FACC, FSCAI4, (1)The University of Washington, Peoria, IL, (2)Cleveland Clinic, Cleveland, OH, (3)OSF St. Francis Medical Center/UICOMP, Peoria, IL, IL, (4)University of Illinois College of Medicine at Peoria, Peoria, IL
Keywords: TAVI/TAVR/Aortic Valve
Background
There is limited use of TAVR in patients with malignancy, given that current guidelines do not recommend TAVR if life expectancy is less than 1 year. Data that compare short-term outcomes after TAVR in patients with malignancy is limited. We Aim to present this data.
Methods
Using the NIS, we identified patients who underwent TAVR from 2016-2017 using ICD10-PCS codes. Patients were subsequently divided based on local malignancy and metastatic malignancy. Primary outcome: In-hospital mortality. Secondary outcome: Total hospital cost/charges, length of hospital stay, and post-procedural complications. Multivariate logistic regression analysis was conducted to adjust for confounders.
Results
A total of 91, 624 TAVR hospitalizations were identified, 4, 995 (4.7%) with malignancy. Patients with malignancy were most likely to be women, have a higher Charlson comorbidity index, to use private insurance, and being admitted to a teaching hospital. The most common malignancy was hematological, head and neck, prostate, digestive, and breast cancer. 15.6% had metastatic disease at the time of TAVR. After adjusting for confounders there was no difference in mortality, LOS, healthcare utilization, and post-procedural complications.
Conclusions
TAVR has safe short-term outcome in patients with active malignancy and metastatic disease. In this population, we recommend having an oncological evaluation to perform a risk assessment to aid in the decision when to not proceed with TAVR.
