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Background: Transcatheter Aortic Valve Replacement (TAVR) has been found to be a safe and effective alternative to Surgical Aortic Valve Replacement (SAVR) in patients with a high/intermediate surgical risk. Comparative outcomes of TAVR vs. SAVR have not been well studied in patients with CKD.
Methods: We used the 2011 – 2013 National Inpatient Database to identify patients undergoing TAVR and SAVR in the setting of CKD stage III to V. Combined SAVR and CABG procedures were excluded. Primary outcomes were in-hospital mortality, post-procedure stroke and dialysis requiring acute kidney injury (AKI). Secondary outcomes included length of stay (LOS) and cost. Multivariate logistic and linear regression models were used to ascertain differences in outcomes.
Results: A total of 4041 TAVR and 9092 SAVR procedures were included in the study. Mean age was 82.6 for TAVR and 74.1 for SAVR group (p<0.001). 43% of TAVR group and 36% of SAVR group were females (p=0.001). In-hospital mortality was similar in the two groups. TAVR group had a significantly lower incidence of dialysis-requiring AKI compared with the SAVR group. Incidence of post-operative stroke was similar in the two groups. LOS was significantly higher for SAVR while cost was similar in the two groups in adjusted models.
Conclusions: In-hospital mortality is similar in patients undergoing TAVR vs. SAVR in the setting of CKD. TAVR is associated with a significantly lower incidence of dialysis requiring AKI compared to SAVR in this population.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-179
- 2017 American College of Cardiology Foundation