Author + information
- Ahmed Almustafa,
- Vinay Badhwar,
- Fahad Alqahtani,
- Sami Aljohani,
- Ali Hama Amin,
- Mohammad Akram Kawsara,
- J. Scott Rankin,
- Lawrence Wei and
- Mohamad Alkhouli
Background: Patients with hepatic cirrhosis undergoing surgical aortic valve replacement (SAVR) have higher perioperative morbidity and mortality compared to non-cirrhotics. Whether transcatheter aortic vavle replacement (TAVR) provides a safer alternative treatment in this high-risk group is unknown. We aim to utilize a nationwide database to assess outcomes of TAVR vs. SAVR in patients with hepatic cirrhosis.
Methods: Using the Nationwide Inpatient Sample and ICD-9 codes, we identified patients with the diagnosis of hepatic cirrhosis who underwent AVR between 2004-2013. In-hospital outcomes were compared between two propensity matched cohorts of patients who underwent TAVR vs. SAVR.
Results: 909 patients with cirrhosis who underwent aortic valve replacement (8.4% TAVR, 91.6% SAVR). Propensity matching yielded 102 Patients (n=51 TAVR, n=51 SAVR). There was no significant difference in in-hospital mortality between the two groups. With the exception of blood transfusion, there was no difference in perioperative complications, lengths of stay and hospital charges.
Conclusions: In a contemporary nationwide sample, there was no significant difference in mortality and key comorbidities between TAVR and SAVR in patients with hepatic cirrhosis. However, this comparison is limited by the small sample size and the inclusion of early TAVR experience. Larger scale studies are needed for comparative effectiveness analysis of TAVR vs. SAVR in these patients with hepatic cirrhosis.
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: 1195-182
- 2017 American College of Cardiology Foundation