Introduction: The influence of previous cardiac surgery (CABG, Valve Replacement or both) on In-hospital clinical outcomes in patients(pts) undergoing Transcatheter Aortic Valve Implantation (TAVI) has not been well established.
Methods: We analyzed the clinical characteristics and periprocedural in-hospital outcomes among pts undergoing TAVI using 2011-2014 HCUP-Nationwide Inpatient Sample database. ICD-9-CM codes were used to identify pts undergoing TAVI with and without history cardiac surgery. Propensity score matching has been attempted to minimize bias. SAS software was used for statistical analysis with p < .05 used to indicate statistical significance.
Results: Among a total of 8466 pts who underwent TAVI during the study period, 1982 had a history of previous cardiac surgery. It was noted that pts with prior cardiac surgery were dominantly male and had a higher prevalence of unfavorable clinical characteristics except pulmonary hypertension (Table). The propensity-matched analysis for 3834 patients showed that the incidence of periprocedural of stroke (2.61% vs1.62%,p=0.03) was lower in pts with previous cardiac surgery. Whereas the prevalence of In-hospital mortality(3.29% vs 2.35% p=0.07), vascular complications(9.96% vs 9.08%,p=0.34), transfusion(23% vs 20.45%,p=0.055), Acute Kidney Injury (AKI)(18.41% vs 16.95%, p=0.23), and pacemaker implantation(10.64 vs 9.29, p=0.16) were comparable for the two cohorts.
Conclusions: In Pts with a history of previous cardiac surgery undergoing TAVI there is a lower incidence of periprocedural stroke compared to those without a history of cardiac surgery. The rates of in-hospital mortality, vascular complications, transfusion, Acute Kidney Injury (AKI), and pacemaker implantation were similar between both the groups.