Outcomes of Patients on Home Oxygen Undergoing Transcatheter Aortic Valve Replacement

Home oxygen use can confer significant mortality risk for cardiac surgery patients. Transcatheter aortic valve replacement (TAVR) is an important option for patients with aortic stenosis on home oxygen. However, post-TAVR outcomes for these patients have not been thoroughly investigated. A single-center retrospective study of all patients on home oxygen who underwent TAVR between 2014 and 2023 was conducted. Primary outcomes included 60-day, 1-year, and 5-year mortality, and postprocedural change in Kansas City Cardiomyopathy Questionnaire (KCCQ-12) score. The final study population included 64 patients. Mortality rates at 60 days, 1 year, and 5 years were 7.8, 23.8, and 85.4%, respectively. KCCQ-12 summary score and all subscores increased between preprocedural screening and 1-year follow-up. Patients surviving beyond 5 years and experiencing improvement in KCCQ-12 score were more likely to have a higher body mass index and less severe chronic lung disease. Only 16.4% of patients were off home oxygen or had decreased oxygen requirements at 1 year. Although patients on home oxygen undergoing TAVR have high mortality rates, their long-term mortality is comparable to overall life expectancy for patients on home oxygen. TAVR can often confer increased quality of life for select patients on home oxygen. However, patients should be counseled on the high risk of morbidity and mortality, and expectations should be set regarding the low likelihood of decreasing oxygen requirements following TAVR.