Author + information
- Sahil Agrawal,
- Lohit Garg,
- Abhishek Sharma,
- Manyoo Agarwal,
- Amitoj Singh,
- Christopher Sarnoski,
- Peter Puleo and
- Jamshid Shirani
Background: Transcatheter aortic valve replacement (TAVR) is recommended for patients with severe symptomatic aortic stenosis and high or prohibitive surgical risk. Data on outcomes of TAVR in the very elderly, who are often denied surgery, are limited.
Methods: We analyzed data from the Nationwide Inpatient Sample for 2011- 2012 to examine differences in clinical characteristics and outcomes of TAVR among nonagenarians (Ng, n=1515), octogenarians (Og, n=4477) and septuagenarians (Sg, n=1920).
Results: Compared to Sg and Og, Ng were less often men (57%-vs-51%-vs-46%) and had lower rates of diabetes (44%-vs-33%-vs-18%), CHF (2.6%-vs-1.6%-vs-0.3%) and COPD (42%-vs-36%-vs-22%) [all p<0.05]. Risk adjusted mortality was higher in Ng (6.5%) compared to Sg (3.6%) (adjusted OR=1.6, 95% CI=1.1-2.4, p=0.02) or Og (4.8%) (adjusted OR=1.4, 95% CI=1.1-1.8, p=0.01). Ng also experienced higher rates of stroke (1%-vs-1.8%-vs-2%), vascular access site injury (5.7%-vs-7.3%-vs-11.7%) and pacemaker implantation (7.6%-vs-8.7%-vs-11.3%) [all p<0.05]. Coagulopathy, peripheral vascular disease, renal failure were more often noted among Ng with adverse outcomes following TAVR (Table).
Conclusions: Ng comprise a sizable minority of patients undergoing TAVR. These patients are at higher risk of in-hospital mortality and experience higher procedural complications rates compared to younger patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 4
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1283-137
- 2017 American College of Cardiology Foundation