Trends, predictors, and outcomes of transcatheter aortic valve implantation in patients with bicuspid aortic valve related disease: Insights from the Nationwide Inpatient Sample and Nationwide Readmission Database.
Catheter Cardiovasc Interv
; 100(6): 1119-1131, 2022 11.
Article
em En
| MEDLINE
| ID: mdl-36183395
ABSTRACT
BACKGROUND:
Transcatheter aortic valve implantation (TAVI) has increasingly been utilized in patients with bicuspid aortic valve (BAV) related aortic stenosis (AS) with insufficient large-scale data on its safety.METHODS:
The Nationwide Inpatient Sample and Nationwide Readmission Database (2011-2018) were queried to identify patients undergoing TAVI for BAV versus trileaflet aortic valve (TAV) associated AS. The in-hospital, 30- and 180-day odds of outcomes were assessed using a propensity-matched analysis (PSM) to calculate adjusted odds ratios (aOR) with its 95% confidence interval (CI).RESULTS:
A total of 216,723 TAVI (TAV 214,050 and BAV 2,673) crude and 5,347 matched population (TAV 2,674 and BAV 2,673) was included in the final analysis. At index admission, the adjusted odds of in-hospital mortality (aOR 1.57, 95% CI 0.67-3.66), stroke (aOR 0.77, 95% CI 0.38-1.57), cardiac tamponade (aOR 0.75, 95% CI 0.17-3.36), vascular complications (aOR 0.33, 95% CI 0.09-1.22), cardiogenic shock (aOR 1.77, 95% CI 0.93-3.38), paravalvular leak (aOR 0.55, 95% CI 0.26-1.14), need for mechanical circulatory support device, and permanent pacemaker implantation (PPM) (aOR 1.02, 95% CI 0.69-1.52) were not significantly different between TAVI for BAV versus TAV. At 30- and 180-day follow-up duration, the risk of stroke and major postprocedural complications remained similar, except that TAVI in BAV had a higher incidence of PPM implantation compared with TAV. The yearly trend showed an increase in the utilization of TAVI for both TAV and BAV and a steady decline in the overall annual rate of in-hospital complications.CONCLUSION:
TAVI utilization in patients with BAV has increased over the recent years. The relative odds of in-hospital mortality, and all other major complications, were similar between patients undergoing TAVI for BAV- and TAV-related AS.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Acidente Vascular Cerebral
/
Substituição da Valva Aórtica Transcateter
/
Doença da Válvula Aórtica Bicúspide
/
Doenças das Valvas Cardíacas
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos