In-hospital outcomes of transapical versus surgical aortic valve replacement:from the U.S.national inpatient sample
Ashraf Abugroun1
Osama Hallak2
Ahmed Taha3
Alejandro Sanchez-Nadales4
Saria Awadalla5
Hussein Daoud6
Efehi Igbinomwanhia7
Lloyd W Klein8
1.Department of Internal Medicine,Medical College of Wisconsin (MCW),WI,USA2.Division of Cardiology,Ketter-ing Medical Center,OH,USA3.Department of Internal Medicine,School of Medicine,Indiana University,Indianapolis,Indiana,USA4.Department of Cardiovascular Disease,Cleveland Clinic Florida,FL,USA5.Division of Epidemiology &Biostatistics,University of Illinois-Chicago,IL,USA6.Division of Cardiology,Creighton University,NE,USA7.Department of Cardiology,Case Western Reserve University (MetroHealth),OH,USA8.University of California,San Francisco(UCSF),San Francisco,CA,USA
摘要：OBJECTIVE To compare the outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) and surgical aortic valve replacement (SAVR) using a large US population sample.METHODS The U.S.National Inpatient Sample was queried for all patients who underwent TA-TAVR or SAVR during the years 2016-2017.The primary outcome was all-cause in-hospital mortality.Secondary outcomes were in-hospital stroke,pericardiocen-tesis,pacemaker insertion,mechanical ventilation,vascular complications,major bleeding,acute kidney injury,length of stay,and cost of hospitalization.Outcomes were modeled using multi-variable logistic regression for binary outcomes and general-ized linear models for continuous outcomes.RESULTS A total of 1560 TA-TAVR and 44,280 SAVR patients were included.Patients who underwent TA-TAVR were older and frailer.Compared to SAVR,TA-TAVR correlated with a higher mortality (4.5％ vs.2.7％,effect size (SMD) =0.1) and higher peri-procedural complications.Following multivariable analysis,both TA-TAVR and SAVR had a similar adjusted risk for in-hospital mortality.TA-TAVR correlated with lower odds of bleeding with (adjusted OR (aOR) =0.26;95％ CI:0.18-0.38;P ＜ 0.001),and a shorter length of stay (adjusted mean ratio (aMR) =0.77;95％ CI:0.69-0.84;P ＜ 0.001),but higher cost (aMR =1.18;95％ CI:1.10-1.28;P ＜ 0.001).No significant differences in other study outcomes.In subgroup analysis,TA-TAVR in patients with chronic lung disease had higher odds for mortality (aOR =3.11;95％CI:1.37-7.08;P =0.007).CONCLUSION The risk-adjusted analysis showed that TA-TAVR has no advantage over SAVR except for patients with chronic lung disease where TA-TAVR has higher mortality.
机标关键词：
论文发表日期：2021-09-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 702-710 )