Impact of Non-Cyanotic Congenital Heart Disease in the Patients Undergoing Transcatheter Aortic Valve Replacement: A Nationwide Inpatient Sample Analysis
Author Type(s)
Faculty
Document Type
Abstract
Publication Date
11-2021
Journal Title
Circulation
Department
Medicine
Abstract
Introduction: Reported total congenital heart disease (CHD) birth prevalence has increased substantially over time. It varies from 1.9 to 9.3 per 1000 live births based on geographic location. Aortic stenosis(AS) is a common pathology associated with advanced age. It is found to be in the 11.7-15.0% population over 75-year-old cohort. TAVR is the preferred intervention for severe AS patients. It is now being performed in extreme- to low-risk patients. We sought to determine the impact of non-cyanotic CHD in the patients undergoing TAVR.
Method: We reviewed National Inpatient Sample (NIS) database from 2016-2018 using Stata 16.0. The NIS is the ICD-10-CM code-based healthcare database. Patients who underwent TAVR were identified and divided into with and without CHD. Multivariate logistic regression, linear regression, and student t-tests were used for analysis.
Results: Among 134,195 patients who underwent TAVR, 1,135(0.9%) were having NCHD. Patients with NCHD were younger (77.9±11.2 vs. 79.6±8.4 with P=0.02) with equal gender distribution. NCHD patients had longer lengths of stay than others (5.9±6.3 vs. 4.3±5.4 with P=<0.001) and were associated with higher co-morbidities such as anemia, atrial fibrillation, and pulmonary hypertension. 55 (4.9%) patients died in the NCHD group, whereas 1956 (1.5%) patients died in the other. The difference was found to be statistically significant on multivariant logistic regression analysis. (OR:2.9, 95%-Confidence Interval: 1.6-5.3, P=<0.001). Complications such as post-operative shock, AMI, AKI, bleeding requiring transfusion, acute respiratory failure, cardiogenic shock, and pacemaker implantation were comparable between both groups. The mean total charge for the NCHD group was $68688, whereas others were $ 54794.
Conclusion: NCHD was associated with higher in-patient mortality and LOS in the patients undergoing TAVR for severe AS. However, Complications were comparable in patients with and without NCHD.
Recommended Citation
Patel, N., Amgai, B., Hajra, A., Chakraborty, S., Patel, Z., Aryal, B., Khalid, M., Paul, P., Singh, S., & Aronow, W. S. (2021). Impact of Non-Cyanotic Congenital Heart Disease in the Patients Undergoing Transcatheter Aortic Valve Replacement: A Nationwide Inpatient Sample Analysis. Circulation, 144 (Suppl. 2), A12435. https://doi.org/10.1161/circ.144.suppl_1.12435
