Author + information
- Konstantinos Voudris1,
- Dmitriy Feldman2,
- Robert Minutello2,
- Luke Kim2,
- Konstantinos Charitakis3,
- Harsimran Singh4,
- Geoffrey Bergman2,
- Arash Salemi5 and
- S. Chiu Wong2
- 1UIC/Advocate Christ Medical Center, Oak Lawn, Illinois, United States
- 2Weill Cornell Medical Center, New York, New York, United States
- 3UTH, Houston, Texas, United States
- 4Weill Cornell Medicine - New York Presbyterian Hospital, New York, New York, United States
- 5New York Presbyterian Hospital - Weill Cornell Medicine, New York, New York, United States
Transcatheter Aortic Valve Replacement (TAVR) has become the standard of care for inoperable, high and intermediate-risk patients with symptomatic severe aortic stenosis. We sought to describe clinical characteristics and in hospital outcomes in patients with prior history of CABG undergoing transapical (TA-TAVR) vs surgical aortic valve replacement (SAVR).
Study population was obtained from the HCUP-NIS database. ICD-9-CM codes were used to identify all patients with history of CABG over the age of 65, undergoing TA-TAVR or SAVR between 2011-2013. Baseline characteristics, in-hospital all-cause mortality, cost and length of hospitalization and procedure related outcomes were assessed. To adjust for multiple confounders propensity score matching was used.
Among 9,464 patients with history of CABG undergoing AVR, TAVR was performed in 11.7% (n=1,112). TAVR patients were more likely to be older females with more frequent adverse clinical characteristics. In-hospital all-cause mortality, length of hospitalization and blood transfusion rates were lower in the TA-TAVR group while incidence of acute kidney injury and permanent pacemaker placement were higher. After propensity score matching, these statistically significant differences persisted with the exception of cost of hospitalization which was higher in the SAVR cohort (Table).
TA-TAVR in patients with prior history of CABG is associated with a lower incidence of in-hospital mortality, blood transfusion and a shorter length of stay but a higher frequency of acute kidney injury and permanent pacemaker placement.
STRUCTURAL: Valvular Disease: Aortic