For a study, researchers sought to see how patients with mixed aortic valve disease (MAVD) fared regarding in-hospital outcomes and readmission rates. Using procedure codes from the Nationwide Readmissions Database and the International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision, a total of 100,573 transcatheter aortic valve implantation (TAVI) procedures were located between 2011 and 2017. Patients with MAVD and those with pure aortic stenosis (AS) were divided into 2 cohorts. All-cause inpatient mortality following TAVI was the main endpoint, while 30- and 90-day readmission rates and postoperative complications were the secondary outcomes. About 3,260 people had MAVD (median age 83 years, 43.5% women). The incidence of paravalvular leak (1.0% vs 1.3%, P=0.056) and in-hospital mortality (2.5% vs 2.6%, P=0.531) was comparable across the MAVD and pure AS groups. The MAVD cohort had lower rates of major bleeding (7.4% vs 9.6%, P<0.001), 30-day readmission (0.5% vs 8.8%, P<0.001), and 90-day readmission rates (0.8% vs 16.0%, P<0.001), acute kidney injury (12.9% vs 15.1%, P<0.001), postoperative ischemic stroke (2.0% vs 5.7%, P<0.001), and mechanic circulatory support use (1.9% vs 4.5%, P<0.001) were less prevalent in the MAVD cohort.  MAVD was not a predictor of mortality in patients who underwent TAVI (adjusted odds ratio [adjOR] 1.25, 95% CI 0.99 to 1.57, P=0.056); however, MAVD was linked to lower odds of 30-day readmission (adjOR 0.05, 95% CI 0.03 to 0.08, P<0.001), higher odds of pacemaker implantation, and lower odds of 90-day readmission rates, (adjOR 0.04, 95% CI 0.03 to 0.06, P<0.001), and higher odds of pacemaker implantation (adjOR 1.46, 95% CI 1.29 to 1.65, P<0.001). In conclusion, TAVI was safe and practicable despite variations in the architecture of the aortic valve and left ventricle (pressure vs. volume-related adaptive alterations in patients with MAVD and pure AS). However, permanent pacemakers were more frequently installed in MAVD patients. The outcomes of the study call for additional randomized controlled studies to support these conclusions.

Source – ajconline.org/article/S0002-9149(22)00404-0/fulltext