E-31 | In-Hospital Complications and Outcomes of Transcatheter Aortic Valve Replacement in Patients with End-Stage Renal Disease

Aortic stenosis frequently coexists with end-stage renal disease (ESRD). Transcatheter aortic valve replacement (TAVR) has emerged as a viable alternative to surgical aortic valve replacement for this population. However, there is limited data on the short-term outcomes and in-hospital complications associated with TAVR in ESRD patients. In this retrospective cohort study, we analyzed data from the United States National Inpatient Sample database spanning from 2016 to 2020. Our cohort comprised 296,740 TAVR patients, of whom 3.67% had a diagnosis of ESRD. Patients were stratified based on ESRD status, and in-hospital complications and length of stay were meticulously evaluated. Among the TAVR recipients, 44.9% were female and 55.1% male. The average age of ESRD patients was 72 years, while non-ESRD patients averaged 79 years. ESRD patients exhibited higher rates of in-hospital mortality (adjusted Odds Ratio [aOR] 2.64; 95% Confidence Interval [CI] 1.98-3.52; P < 0.001), cardiogenic shock (aOR 2.38; 95% CI 1.92-2.96; P < 0.001), acute coronary syndrome (aOR 2.48; 95% CI 2.03-3.02; P < 0.001), mechanical ventilation necessity (aOR 2.42; 95% CI 1.98-2.96; P < 0.001), pericardial complications including tamponade (aOR 1.85; 95% CI 1.42-2.41; P < 0.001), vascular complications (aOR 1.43; 95% CI 1.09-1.88; P = 0.009), gastrointestinal bleeding (aOR 2.75; 95% CI 1.78-4.25; P < 0.001), ischemic stroke (aOR 1.55; 95% CI 1.15-2.08; P < 0.004). ESRD patients also had a longer length of stay (coefficient 2.86; p <0.001). Our study reveals substantial disparities in in-hospital complications and outcomes between ESRD and non-ESRD patients undergoing TAVR. The increased risk of adverse events in ESRD patients emphasizes the need for tailored interventions and heightened clinical attention to optimize the safety and efficacy of TAVR in this specific population.