TY - JOUR
T1 - Trends, predictors, and outcomes of transcatheter aortic valve implantation in patients with bicuspid aortic valve related disease
T2 - Insights from the Nationwide Inpatient Sample and Nationwide Readmission Database
AU - Ullah, Waqas
AU - Zahid, Salman
AU - Muhammadzai, Hamza
AU - Khalil, Fouad
AU - Kumar, Arnav
AU - Minhas, Abdul Mannan Khan
AU - Khan, Muhammad Zia
AU - Virani, Salim S.
AU - Fischman, David L.
AU - Shah, Pinak
AU - Bhatt, Deepak L.
N1 - Publisher Copyright:
© 2022 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.
PY - 2022/11/15
Y1 - 2022/11/15
N2 - 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.
AB - 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.
KW - AS—aortic stenosis
KW - TAVI-transcatheter aortic valve implantation
UR - http://www.scopus.com/inward/record.url?scp=85139035534&partnerID=8YFLogxK
U2 - 10.1002/ccd.30407
DO - 10.1002/ccd.30407
M3 - Article
C2 - 36183395
AN - SCOPUS:85139035534
SN - 1522-1946
VL - 100
SP - 1119
EP - 1131
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 6
ER -