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Peripheral vascular disease (PVD) plays an important role in patients evaluated for transcatheter aortic valve replacement (TAVR). We conducted this study to evaluate PVD patients undergoing TAVR procedure.
Study population was extracted from the National Readmission Data (NRD) 2014 using International Classification of Diseases ninth (ICD-9) codes for TAVR, PVD and periprocedural complications. Propensity matching was used to extract a matched control group of TAVR patients without history of PVD (TAVR-C) to the TAVR group with history of PVD (TAVR-PVD). Both groups were comparable in terms of baseline characteristics and 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), stroke and 30-day readmission rates.
A total of 2589 patients were identified in each group. Mean age was 80.2 years, and 48.5% were male. TAVR-PVD was associated with significantly higher likelihood of VAC (4.4% versus 2.6%, p<0.01) and significantly lower likelihood of AMI (3.1% versus 4.4%, p=0.02), AKI (16.4% versus 20.8%, p<0.01), mechanical complications of heart valve prosthesis (1.9% versus 2.9%, p=0.02) and shorter mean LOS (8.5 versus 9.9 days, p<0.01). There was no significant difference between both groups in terms of all-cause in-hospital mortality (4.2% versus 4.1%, p=0.83), bleeding (36.9 versus 35.3%, p=0.24), stroke (5.4% versus 5.4%, p<0.95), PPM (0.6% versus 0.5%, p=0.84) or 30-day readmission rates (18.1% versus 19.0%, p=0.47).
In comparison to TAVR-C, TAVR-PVD was associated with higher VAC and lower periprocedural AMI, AKI, mechanical complications of heart valve prosthesis and shorter LOS. There was no significant difference in terms of all-cause in-hospital mortality, bleeding, PPM or 30-day readmission rates.