OR07-9
Impact of Endocarditis on Post TAVR Patients: Insight from The National Readmission Database
Presenter
Sadaf Fakhra, University of Nevada Las Vegas, Las Vegas, NV
Sadaf Fakhra1, Omar Al-Taweel, MD2, Neel N Patel, MD3, Blaine Massey, DO1 and Chowdhury Ahsan, M.D.4, (1)University of Nevada Las Vegas, Las Vegas, NV, (2)Northwell Health Lenox Hill Hospital, New York, NY, (3)New York Medical College/Landmark Medical Center, Woonsocket, MI, (4)UNIVERSITY MEDICAL CENTER, LAS VEGAS, Las Vegas, NV
Keywords: TAVI/TAVR/Aortic Valve
Background
: Although rare, infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) can have devastating consequences. Multiple studies have highlighted the increase in TAVR complications up to 2018. In this retrospective study we aim to expand on this by looking at data from 2016-2020 and also shed light on readmission rates.
Methods
: We used the national readmission database (NRD) from 2016-2020 using ICD-10 codes to compare different outcomes between post TAVR patients with (w) IE and without (w/o) IE. End points included in-hospital mortality, acute and hemorrhagic stroke, cardiogenic shock, and readmission.
Results
: Of the 320,353 patients with TAVR, 706 developed IE (0.22%). Median age was 80 for patients w/o IE and 76 for patients w IE. Median LOS was 2 days for patients w/o IE vs. 10 days in IE group. Propensity-matched data showed higher in-hospital mortality (0.7% vs. 7.2%, p<0.001), cardiogenic shock (2.7% vs. 15.3%, p<0.001), ischemic (0.7% vs. 2.8%, p=0.031), and hemorrhagic stroke (0.1% vs. 1%, p=0.045) in patients w IE. Patients w IE also were more likely to be readmitted at 30, 90, and 180 days.
Conclusions
: IE can result in higher rates of adverse outcomes including mortality and readmission in patients after TAVR. Vigilant preventive measures, such as more aggressive antibiotic prophylaxis protocols perioperatively are crucial. 