Author + information
Transcatheter aortic valve replacement (TAVR) outcomes have recently emerged as an alternative therapy for moderate to high surgical risk patients with aortic stenosis. In this study we describe the effect of concomitant mitral valve regurgitation (MR) on TAVR periprocedural outcomes.
The study population was extracted from National Readmission Data (NRD) 2014 using International Classification of Diseases ninth (ICD-9) codes for TAVR, MR and periprocedural outcomes. Propensity matching was used to extract a matched control group of TAVR patients without MR (TAVR-C) to the TAVR with concomitant MR group (TAVR-MR). Both groups were comparable in terms of baseline characteristics and number of co-morbidities. Study endpoints included all-cause in-hospital mortality, length of index hospital stay (LOS), acute myocardial infarction (AMI), acute kidney injury (AKI), bleeding, mechanical complications of heart valve prosthesis (including paravalvular leak and valve dislodgement), vascular access complications (VAC), need for new pacemaker implantation (PPM) and 30-day readmission rates.
A total of 1143 patients unweighted (2491 weighted) were identified in each group. Average age was 81.5 years, and 49% were male. There was no significant difference between both groups in terms of all-cause in-hospital mortality (4.4% versus 4%, p=0.67), mean LOS (9.7 versus 9.4 days, p=0.58), AMI (4.0% versus 3.3%, p=0.32), AKI (19.0% versus 20.6%, p=0.33), bleeding (33.5 versus 35.6%, p=0.28), mechanical complications of heart valve prosthesis (2.2% versus 2.6%, p=0.48), VAC (0.8% versus 1.3%, p=0.22), PPM (0.7% versus 0.5%, p=0.59) or 30-day readmission rates (19.0% versus 19.1%, p=0.95).
When compared with TAVR-C, TAVR-MR had similar outcomes of all-cause in-hospital mortality, LOS, AMI, AKI, bleeding, mechanical complications of heart valve prosthesis, VAC, PPM or 30-day readmission rates.