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Transcatheter aortic valve replacement (TAVR) has emerged as an alternative therapy for moderate to severe aortic stenosis. It is unknown if prior history of coronary artery bypass surgery has influence on procedural characteristics or hospital outcomes in patients undergoing TAVR.
Study population was extracted from The National Readmission Data (NRD) 2014 using International Classification of Diseases ninth (ICD-9) codes for TAVR, coronary artery bypass graft (CABG) and periprocedural complications. Propensity matching was used to extract a matched control group of TAVR patients without history of CABG (TAVR-C) to the TAVR group with history of CABG (TAVR-CABG). Both groups were comparable in terms of baseline characteristics and co-morbidities. Study endpoints included all-cause in-hospital mortality, acute myocardial infarction (AMI), complications of heart valve prosthesis (including paravalvular leak and valve dislodgement), vascular access complications (VAC), the need for new pacemaker implantation (PPM) and 30-day readmission rates.
A total of 2253 patients were identified in each group. Mean age was 80.2 years, and 48.5% were male. There was no significant difference between both groups in terms of all-cause in-hospital mortality (3.1% versus 4.0%, p=0.09), AMI (3.2% versus 3.3%, p=0.93), mechanical complications of heart valve prosthesis (3.0% versus 3.1%, p=0.93), VAC (0.5% versus 0.9%, p=0.12), PPM (0.4% versus 0.5%, p=0.83) or 30-day readmission rates (16.5% versus 18.2%, p=0.19).
When compared to TAVR-C, TAVR-CABG was associated with similar rates of all-cause in-hospital mortality, LOS, AMI, AKI, mechanical complications of heart valve prosthesis, VAC, PPM or 30-day readmission rates.