In-Hospital Outcome in Patients With Acyanotic Congenital Heart Disease Undergoing Transcatheter Aortic Valve Replacement

Authors

Sandipan Chakraborty, Department of Medicine, Miami Valley Hospital, Columbus, OH.
Manasvi Gupta, Department of Medicine, University of Connecticut, Farmington, CT.Follow
Dhrubajyoti Bandyopadhyay, Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY. Electronic address: drdhrubajyoti87@gmail.com.
Neelkumar Patel, Department of Cardiology, University of Kansas, Kansas City, KS.Follow
Adrija Hajra, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
Aaqib Malik, Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY.Follow
Akshay Goel, Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY.
Ahmed Hassanin, Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY.
Rahul Gupta, Department of Cardiology, Lehigh Valley Health Network, Allentown, PA.Follow
Chayakrit Krittanawong, Department of Cardiology, Baylor College of Medicine, TX.
Ahmad Hasan, Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY.

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1016/j.cpcardiol.2022.101352

Journal Title

Current Problems in Cardiology

First Page

101352

Document Type

Article

Publication Date

12-1-2022

Department

Medicine

Abstract

The purpose of the study was to determine the in-hospital outcome and resource utilization in patients with acyanotic congenital heart disease (ACHD) undergoing transcatheter aortic valve replacement (TAVR). Current guidelines from professional societies do not support TAVR in patients with ACHD, likely from a lack of supportive evidence. Temporal trends in patients with ACHD undergoing TAVR were determined using the 2016-2018 National Inpatient Sample database appropriate ICS-10-PCS code. Stata 16.0 was used for statistical analysis. 0.87% of patients undergoing TAVR had concomitant ACHD, with ASD being the most common (78%). After matching, there was no increased risk of mortality in ACHD patients undergoing TAVR compared to patients without ACHD (OR 1.43, P = 0.59). Additionally, no difference was found in the incidence of overall cardiac complications between patients with ACHD and patients without ACHD, except STEMI (OR 4.16, 95% CI, 1.08-16.00, P = 0.038), which is likely due to more comorbidity burden in the later cohort. Complications such as acute kidney injury, ischemic stroke, and bleeding were similar. Hospital resource utilization was higher in the ACHD group in the form of increased length of stay and higher mean total cost. The comparable in-hospital all-cause mortality and complication rate in ACHD patients undergoing TAVR compared to patients without ACHD is encouraging and will be helpful to design future randomized controlled trials.

Recommended Citation

Chakraborty, S., Gupta, M., Bandyopadhyay, D., Patel, N., Hajra, A., Malik, A., Goel, A., Hassanin, A., Gupta, R., Krittanawong, C., & Hasan, A. (2022). In-Hospital Outcome in Patients With Acyanotic Congenital Heart Disease Undergoing Transcatheter Aortic Valve Replacement. Current Problems in Cardiology, 47 (12), 101352. https://doi.org/10.1016/j.cpcardiol.2022.101352