E-15 | Transcatheter Aortic Valve Replacement After Coronary Artery Bypass Graft Surgery: Looking Good But We Should Keep Looking

: Although transcatheter aortic valve replacement (TAVR) has become the default strategy for most patients with severe aortic stenosis, a history of prior coronary artery bypass graft surgery (CABG) is a compelling reason to avoid redo surgery. We assessed the in-hospital outcomes of TAVR patients with and without a history of prior CABG. Data was collected for quality assurance on all patients that underwent TAVR between 2021-2022 at 4 New York metropolitan area hospitals. Data on all patients was entered into the STS ACC TAVR registry. Outcomes and bleeding were classified according to the Valve Academic Research Consortium (VARC-3). Statistical significance was assessed using Mann-Whitney U tests for continuous variables and Chi-square tests for categorical variables. A p-value <0.05 was considered statistically significant. A total of 1,796 patients underwent TAVR between 2021 and 2022, 258 had a history of prior CABG and 1,538 did not. There was a higher incidence of peripheral arterial disease in post-CABG patients (Table). In-hospital bleeding complications were similar in both groups, albeit a trend for higher VARC Type 2 in post-CABG patients (p=0.06). Vascular complications, rate of post TAVR pacemaker implantations, and stroke rates were similar between the two groups. : In patients undergoing TAVR, a prior history of CABG was not associated with worse in-hospital outcomes. Although mortality rates were three times higher in these patients, it did not reach statistical significance. Further analysis in a larger cohort is warranted.