Tomo Ando1, Alexandros Briasoulis2, Hisato Takagi3, Tesfaye Telila4, Cindy L Grines5, Aaqib H Malik6. 1. Division of Cardiology, Center for Interventional Vascular Therapy, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA. 2. Division of Cardiology, University of Iowa Hospitals and Clinics, Iowa, Iowa, USA. 3. Division of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan. 4. Division of Interventional Cardiology, Piedmont Hospital, Atlanta, Georgia, USA. 5. Division of Cardiology, Northside Hospital Cardiovascular Institute, Atlanta, Georgia, USA. 6. Division of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
Abstract
BACKGROUND AND AIM: Trends of utilization and outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) for patients on chronic dialysis (CD) are not well described. We aimed to assess the trends in utilization and outcomes of TAVR and SAVR on CD. METHODS: Nationwide Readmission Databases from 2013 to 2017 was analyzed. International Classification of Diseases Clinical Modification 9 and 10 codes were used to identify diagnoses and procedures. A multivariable regression model was used to compare the outcomes expressed as adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS: A total of 5731 TAVR and 6491 SAVR were performed in patients with CD, respectively. The volume of TAVR increased by approximately four-folds and SAVR increased by approximately 33%. However, amongst patients with CD, the percentage of TAVR increased, whereas that of SAVR decreased (p < .001 for all). In 2016 and 2017, TAVR volume surpassed that of SAVR on CD. In-hospital mortality remained similar in TAVR (aOR: 0.92; 95% CI: 0.79-1.07; p-trend = .23) whereas it increased significantly in SAVR (aOR: 1.14: 95% CI: 1.05-1.25, p-trend = .002). In 2017, in-hospital mortality and 30-day readmission were significantly higher in TAVR among CD than non-CD patients. CONCLUSION: Despite increased use of TAVR among CD, there still is an opportunity for improvement in outcome of aortic valve replacement for those on CD.
BACKGROUND AND AIM: Trends of utilization and outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) for patients on chronic dialysis (CD) are not well described. We aimed to assess the trends in utilization and outcomes of TAVR and SAVR on CD. METHODS: Nationwide Readmission Databases from 2013 to 2017 was analyzed. International Classification of Diseases Clinical Modification 9 and 10 codes were used to identify diagnoses and procedures. A multivariable regression model was used to compare the outcomes expressed as adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS: A total of 5731 TAVR and 6491 SAVR were performed in patients with CD, respectively. The volume of TAVR increased by approximately four-folds and SAVR increased by approximately 33%. However, amongst patients with CD, the percentage of TAVR increased, whereas that of SAVR decreased (p < .001 for all). In 2016 and 2017, TAVR volume surpassed that of SAVR on CD. In-hospital mortality remained similar in TAVR (aOR: 0.92; 95% CI: 0.79-1.07; p-trend = .23) whereas it increased significantly in SAVR (aOR: 1.14: 95% CI: 1.05-1.25, p-trend = .002). In 2017, in-hospital mortality and 30-day readmission were significantly higher in TAVR among CD than non-CDpatients. CONCLUSION: Despite increased use of TAVR among CD, there still is an opportunity for improvement in outcome of aortic valve replacement for those on CD.
Authors: William L Patrick; Zehang Chen; Jason J Han; Benjamin Smood; Akhil Rao; Fabliha Khurshan; Siddharth Yarlagadda; Amit Iyengar; John J Kelly; Joshua C Grimm; Marisa Cevasco; Joseph E Bavaria; Nimesh D Desai Journal: Cardiol Ther Date: 2022-03-31