Contemporary Trends, Characteristics, and Safety Outcomes Associated With Transcatheter Aortic Valve Replacement in Nonagenarians: Large Database Analysis of 23,507 Patients
Author Type(s)
Resident/Fellow
Document Type
Abstract
Publication Date
2022
Journal Title
Journal of the American College of Cardiology
Department
Medicine
Abstract
Background: Aortic stenosis (AS) is very common in the elderly population. Transcatheter aortic valve replacement (TAVR) has been increasingly used in nonagenarians. However, contemporary data on outcomes are scarce. Methods: The National Readmission Database of the years 2016 to 2019 was queried for nonagenarians who underwent TAVR. December discharges were excluded to allow 30-day follow-up. Logistic and linear regression analysis was used to calculate the temporal trends in categoric and continuous outcomes, respectively. The outcomes evaluated were in-hospital mortality, 30-day readmission, permanent pacemaker implantation, stroke, acute kidney injury (AKI), and length of stay. Results: A total of 23,507 TAVR nonagenarian admissions (50.3% female and 95.9% Medicare insurance) were included in our cohort. Congestive heart failure and hypertension were present in 79% and 89% of patients, respectively. In-hospital mortality and all-cause 30-day readmissions were 2% and 15% and have been stable over years of analysis (P trend = 0.79 and 0.06, respectively). The complications evaluated were permanent pacemaker implantation in-hospital or on readmission (12%), acute kidney injury (12%), stroke in-hospital or on readmission (0.5%), cardiac tamponade (0.2%), and acute limb ischemia (0.2%). The mean length of stay improved from 5.5 days in 2016 to 4.3 days in 2019 (P trend < 0.01). Stroke rates have improved from 1.2% to 0.3% in 2016 and 2019, respectively (P trend <0.01) (Figure 1). [Formula presented] Conclusion: Our analysis showed contemporary trends of TAVR short-term outcomes. The development of new strategies is needed to improve certain outcomes in this age group. Categories: STRUCTURAL: Valvular Disease: Aortic
Recommended Citation
Maraey, A., Abdelmottaleb, W., Ozbay, M., Elsharnoby, H., Khalil, M., & Elzanaty, A. (2022). Contemporary Trends, Characteristics, and Safety Outcomes Associated With Transcatheter Aortic Valve Replacement in Nonagenarians: Large Database Analysis of 23,507 Patients. Journal of the American College of Cardiology, 80 (12), B180. https://doi.org/10.1016/j.jacc.2022.08.526
