Advertisement

 

 

In-hospital outcomes of transcatheter versus surgical aortic valve replacement in end stage renal disease.

In-hospital outcomes of transcatheter versus surgical aortic valve replacement in end stage renal disease.
Author Information (click to view)

Alkhalil A, Golbari S, Song D, Lamba H, Fares A, Alaiti A, Deo S, Attizzani GF, Ibrahim H, Ruiz CE,


Alkhalil A, Golbari S, Song D, Lamba H, Fares A, Alaiti A, Deo S, Attizzani GF, Ibrahim H, Ruiz CE, (click to view)

Alkhalil A, Golbari S, Song D, Lamba H, Fares A, Alaiti A, Deo S, Attizzani GF, Ibrahim H, Ruiz CE,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2017 11 24() doi 10.1002/ccd.27433
Abstract
BACKGROUND
Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at intermediate and high risk for surgery. Commercial use of TAVR has expanded to patients with end stage renal disease (ESRD).

OBJECTIVES
Compare in-hospital outcomes of TAVR versus SAVR in ESRD patients requiring hemodialysis (HD).

METHODS
ESRD patients on HD undergoing TAVR (n = 328) or SAVR (n = 697) between 2012 and 2014 were identified in the National Inpatient Sample (NIS). Propensity-score matching method was used to minimize selection bias. Baseline characteristics and in-hospital outcomes were compared.

RESULTS
TAVR patients were older (75.3 vs. 61.6 years, P < 0.001) and had more comorbidities, including congestive heart failure (16.2% vs. 7.5%), diabetes mellitus (28.4% vs. 22.5%), chronic lung disease (27.7% vs. 20.4%), and peripheral vascular disease (35.1% vs. 21.2%). Propensity-score matching yielded 175 pairs of patients matched on 30 baseline covariates. Overall in-hospital mortality was high (9.9%) and similar between TAVR and SAVR (8% vs. 10.3%, P = 0.58). TAVR was associated with shorter length of stay (LOS) (8 vs. 14 days, P < 0.001), lower hospitalization cost ($276,448 vs. $364,280, P = 0.01), lower in-hospital complications (60.6% vs. 76%, P = 0.003), and higher rate of home discharge (31.4% vs. 17.7%, P = 0.004) compared with SAVR. CONCLUSIONS
Regardless of treatment modality, patients with AS on HD have high in-hospital mortality. TAVR and SAVR have comparable in-hospital mortality in this population. However, TAVR is associated with shorter LOS, lower hospitalization costs, lower in-hospital complications, and higher rates of home discharge.

Submit a Comment

Your email address will not be published. Required fields are marked *

19 − six =

[ HIDE/SHOW ]