Author + information
Transaortic Valve Replacement (TAVR) with percutaneous coronary intervention (PCI) is less invasive option for high risk patients with aortic stenosis (AS) with coronary artery disease (CAD). The aim of our study is to compare outcomes and length of stay of TAVR with PCI and Surgical Aortic valve Replacement (SAVR) plus coronary artery bypass grafting (CABG).
We identified 1470 patients from NIS database from 2011-2013 using ICD 9 CM procedure code (35.21,35.22 for SAVR, 35.05,35.06 for TAVR, 36.10-17,36.19 for CABG and 0.66,36.04,36.06,36.07 for PCI). 695 patients underwent TAVR with PCI while 775 underwent SAVR with CABG. Univariate and Multivariate analysis were performed using SAS 9.4 (SAS institute Inc, Cary, NC).
Compared to the SAVR+CABG group, TAVR+PCI group had higher comorbidities. Female and white people were predominant in TAVR+PCI group. In-Hospital outcomes were higher with TAVR+PCI group. Secondary outcomes were higher with TAVR+PCI group as well except blood transfusion.
In a population of patients traditionally cared for by SAVR with CABG, TAVR with PCI demonstrated significant reductions in in-hospital mortality, stroke and overall outcomes. TAVR has gained significant momentum for the care of high risk patients, but as the risk profile decreases to include low and intermediate risk patients, it is even more imperative to demonstrate equivalent if not superiority of TAVR with PCI to SAVR with CABG.