Transcatheter and Surgical Aortic Valve Replacement Outcomes for Patients with Chronic Heart Failure
| Autor: | John Zaki, Warren Choi, Cooper Quiroz, Igor D. Gregoric, Rabail Chaudhry, Julius Balogh, Biswajit Kar, Talha Mubashir, Yafen Liang, Travis H. Markham, Rishi Kumar, Ismael A. Salas de Armas, George W. Williams, Bindu Akkanti |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart block medicine.medical_treatment Population 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement 03 medical and health sciences Postoperative Complications 0302 clinical medicine Aortic valve replacement Valve replacement Risk Factors 030202 anesthesiology Internal medicine medicine Humans Hospital Mortality education Aged Retrospective Studies Heart Failure Heart Valve Prosthesis Implantation education.field_of_study business.industry Mortality rate Aortic Valve Stenosis medicine.disease Comorbidity United States Stenosis Treatment Outcome Anesthesiology and Pain Medicine Aortic Valve Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 35:888-895 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2020.06.082 |
| Popis: | Objectives To determine in-hospital outcomes and assess high-risk groups among chronic heart failure (CHF) patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Design A retrospective analysis of the Nationwide Inpatient Sample database from January 2012 to September 2015 was performed. Setting Hospitals across the United States that offer TAVRs or SAVRs. Participants Adults with a diagnosis of CHF and AS. Interventions The patients underwent either TAVR or SAVR. Measurements and Main Results Totals of 5,871 and 4,008 CHF patients underwent TAVR and SAVR, respectively. TAVR patients were significantly older, more were female, and had a higher comorbidity burden. No significant differences in in-hospital mortality were noted between TAVR and SAVR. However, mean length of stay was significantly longer by 3.5 days in the SAVR group, as was the mean total cost. With the exception of complete heart block, permanent pacemaker implantation, and vascular complications, the majority of postoperative events were higher among the SAVR group. Multivariate regression analysis identified postoperative cardiac, respiratory and renal complications as significant predictors of in-hospital mortality for both groups. Additionally, age ≥75 years and vascular complications were significant predictors of mortality for patients undergoing TAVR. Conclusions Among CHF patients with symptomatic AS, TAVR had similar in-hospital mortality rate compared with SAVR despite higher comorbidity burden. TAVR patients are at a lower risk of cardiovascular, respiratory, and renal complications and might lead to reduced length of hospital stay and cost. Hence, TAVR may be a safer option in this population. |
| Databáze: | OpenAIRE |
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