In-Hospital Outcomes of Transcatheter Aortic Valve Replacement in Patients with Mitral Valve Stenosis

Abstract

Abstract: Background: Little is known about the outcome of patients with MS undergoing transcatheter aortic valve replacement (TAVR). Therefore, we sought to evaluate the potential impact of MS on the outcome of
patients who underwent TAVR using the US national cohort.

Method: Using weighted data from the National Inpatient Sample (NIS) database between 2011 and 2015, we identified patients who had undergone a TAVR as a primary procedure. Patients with MS diagnosis were compared to those without MS. Univariate and multivariate logistic regression analysis were performed for the outcomes of in-hospital mortality and
post-procedural complications. Outcomes were also stratified by the type to TAVR (endovascular versus transapical).

Results: A total of 62,110 patients underwent TAVR (mean age 81 ± 8.72, 47.4% females, and 3.7% African Americans) and 887 patients had MS (1.43%). Patients with concomitant MS had higher in-hospital mortality (5.1% vs 3.5% adjusted Odds Ratio [aOR], 1.455; 95% confidence interval [CI], 1.059-2.001, P=0.021), major adverse cardiac events (MACE) (9.0% vs
7.1% aOR, 1.297; 95% CI, 1.012-1.663, P=0.040), major bleeding (16.3% vs 12.1% aOR, 1.303; 95% CI, 1.067-1.593, P=0.010), cardiac complications (21.8% vs 16.0% aOR, 1.536; 95% CI, 1.300-1.815, P<0.001) and acute myocardial infarction (AMI) (4.5% vs 2.8% aOR, 1.783; 95% CI, 1.249-2.545, P=0.007) when compared with patients without MS.

Conclusion: Mitral stenosis is an independent risk factor for mortality and morbidity after TAVR procedure for patients with severe AS.