E-53 | In-Hospital Outcomes of Transcatheter Aortic Valve Replacement versus Surgical Aortic Valve Replacement in Bicuspid Aortic Valve Stenosis: A Propensity Matched Cohort

Transcatheter Aortic Valve Replacement (TAVR) shows superior in-hospital outcomes over Surgical Aortic Valve Replacement (SAVR) in aortic stenosis, there is a notable gap in the existing literature regarding in-hospital outcomes for patients with bicuspid aortic valve (BAV) stenosis. Our objective is to examine inpatient outcomes, comparing TAVR to SAVR specifically in the context of bicuspid aortic valve stenosis. The national readmission database (2016-2020) identified BAV stenosis hospitalizations. Cohorts were stratified by TAVR and SAVR for BAV stenosis. A Propensity Score Matching (PSM) model matched interventions in BAV stenosis patients. Pearson's χ2 test compared outcomes in PSM-2 matched cohorts. Among 44,225 hospitalized patients with BAV stenosis, 5,148 underwent TAVR and 39,077 underwent SAVR. After propensity matching (N=20,723), patients who underwent TAVR had elevated adverse events including major adverse cardiovascular events (MACE) (12.28% vs 8.74%, p <0.001), acute kidney injury (15.03% vs 13.54%; p <0.001), myocardial infarction (7.69% vs 5.09%; p <0.001), sudden cardiac arrest (1.81% vs 1.22%; p <0.001), and cardiogenic shock (7.74% vs 5.12%, p <0.001) compared to SAVR. Although, TAVR patients had lower vasopressor requirements (6.97% vs 9.38%, p <0.001), postprocedural bleeding (2.3% vs 3.19%, p <0.001), and transfusion requirements (9,59% vs 15.20%; p <0.001) compared to SAVR patients. No significant difference in mortality was observed between the two procedures (p>0.05) For BAV stenosis, TAVR exhibits increased MACE and cardiovascular complications but decreased vasopressor requirements and postprocedural bleeding compared to SAVR. Mortality difference between the two procedures was not significant. Further research is needed to elucidate outcome disparities between TAVR and SAVR in BAV stenosis.