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B-39 | Transcatheter Aorticvalve Replacement versus Surgical Aortic Valve Replacement in Aortic Stenosis Complicated by Cardiogenic Shock
Khalid, Yaser Gabriel, Nielsen Umrani, Rohan Roy, Trinava Dasu, Kirti Dasu, Neethi
Khalid, Yaser
Gabriel, Nielsen
Umrani, Rohan
Roy, Trinava
Dasu, Kirti
Dasu, Neethi
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2023-05-18
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https://doi.org/10.1016/j.jscai.2023.100761
Abstract
Background: Patients with aortic valve stenosis (AS) can develop cardiogenic shock. TAVR is a viable option for patients with cardiogenic shock despite increased mortality. Previous studies have shown that even though mortality is increased, mortality was not related to procedural complications but rather due to the cardiogenic shock itself. Our study aimed to compare the inpatient outcomes of transcatheter aortic valve replacement (TAVR) versus Surgical aortic valve replacement (SAVR) in hospitalized patients with AS and concomitant cardiogenic shock. Methods: We conducted a retrospective cohort analysis of the National Inpatient Sample 2017 database. Patients with diagnosis of both AS and CAD were identified using the ICD-10 codes. Multivariate logistic regression was used to adjust for patient baseline characteristics, hospital demographics and relevant comorbidities. Primary outcomes, inpatient mortality, length of hospital stay (LOS) and total hospital charges. Results: A total of 853 patients with both AS and cardiogenic shock were included. Of these, 198 (23%) received TAVR and 655 (77%) received SAVR. Patients in the TAVR group were older than the SAVR group (67.0 vs. 65.2 years). SAVR was associated with a longer hospital LOS than TAVR (17.7 days vs 14.4 days, OR 2.82, p<0.005). There was no statistically significant difference between mortality (17.6% vs 21.3%, OR 1.24, p<0.214) and total hospital charges ($470,000 vs $420,000, OR 1.38, p<0.167). Furthermore, SAVR patients had higher gastrointestinal hemorrhage (OR 2.19, p<0.029) and AKI (OR 5.35, p<0.0001). There was no statistically significant difference in RF (p<0.493), CVA/TIA (p<0.477), and ICH (0.392). Conclusions: Even with an older patient population and worse left ventricular function, TAVR has been shown in previous studies to have comparable mortality compared to SAVR in patients with cardiogenic shock. Our study revealed that there was no significant difference in mortality and total hospital charges between TAVR and SAVR for this patient population. However, patients with TAVR interestingly had a shorter hospital LOS and SAVR patients had higher gastrointestinal bleeding.
Disclosures: Y. Khalid Nothing to disclose. N. Gabriel Nothing to disclose. R. Umrani Nothing to disclose. T. Roy Nothing to disclose. K. Dasu Nothing to disclose. N. Dasu Nothing to disclose.
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Yaser Khalid, Nielsen Gabriel, Rohan Umrani, Trinava Roy, Kirti Dasu, Neethi Dasu, B-39 | Transcatheter Aorticvalve Replacement versus Surgical Aortic Valve Replacement in Aortic Stenosis Complicated by Cardiogenic Shock, Journal of the Society for Cardiovascular Angiography & Interventions, Volume 2, Issue 3, Supplement, 2023, 100761, ISSN 2772-9303, https://doi.org/10.1016/j.jscai.2023.100761.
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Elsevier
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Journal of the Society for Cardiovascular Angiography & Interventions, Vol. 2, Iss. 3, Supp.
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