Abstract | BACKGROUND: METHODS: Using the National Inpatient Sample, we identified all adult admissions with a diagnosis of aortic stenosis. Subgroups of SAVR+CABG and TAVR+PCI formed the study group. Outcomes of interest included total hospitalization charges, temporal trends, in-hospital mortality, and complications. RESULTS: Between 2012 and 2017, a total of 97 955 admissions (95.9%) received SAVR+CABG, and 4240 (4.1%) received TAVR+PCI; the proportion of TAVR+PCI increased from 1% in 2012 to 9.2% in 2017 (P < .001). Compared with patients receiving TAVR+PCI, admissions receiving SAVR+CABG were younger, more likely to be male, and had lower comorbidity (all P < .001). Adjusted in-hospital mortality was comparable in both groups (odds ratio 0.94; 95% confidence interval, 0.79 to 1.11; P = .45). Higher rates of pacemaker implantation, cardiac arrest, and vascular complications were seen in the TAVR+PCI group, whereas SAVR+CABG was associated with a greater requirement for prolonged ventilation. Admissions receiving TAVR+PCI had shorter lengths of hospital stay and were more likely to be discharged home. Nevertheless, the TAVR+PCI group had higher hospitalization charges compared with the SAVR+CABG group (all P < .001). CONCLUSIONS: There has been a steady increase in the use of percutaneous strategies for aortic stenosis and coronary artery disease management. In-hospital mortality was comparable in SAVR+CABG and TAVR+PCI groups, but despite shorter in- hospital stays, TAVR+PCI was associated with higher cardiac and vascular complication rates and hospitalization charges.
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Authors | Sri Harsha Patlolla, Hartzell V Schaff, Joseph A Dearani, John M Stulak, Juan A Crestanello, Kevin L Greason |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 114
Issue 3
Pg. 659-666
(09 2022)
ISSN: 1552-6259 [Electronic] Netherlands |
PMID | 34560043
(Publication Type: Journal Article)
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Copyright | Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Topics |
- Aortic Valve
(surgery)
- Aortic Valve Stenosis
- Coronary Artery Disease
- Female
- Heart Valve Prosthesis Implantation
- Hospital Mortality
- Humans
- Male
- Percutaneous Coronary Intervention
- Risk Factors
- Transcatheter Aortic Valve Replacement
- Treatment Outcome
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