C-82 | Clinical Outcomes of Transcatheter Aortic Valve Replacement in Patients With Prior Mitral Valve Replacement: A TriNetX Retrospective Cohort Study

Background: Transcatheter aortic valve replacement (TAVR) is frequently used for treatment of severe aortic stenosis as an alternative to surgical aortic valve replacement .Patients with prior prosthetic mitral valves (PMV) were excluded from initial TAVR trials .In this study , we compare the outcomes between patients who underwent TAVR with vs without prior PMV valves.Methods: We conducted a retrospective cohort study using TriNetX US Researtch network across participating Healthcare organizations (HCOs).Adults aged 18 years undergoing TAVR.Two cohorts were defined: TAVRI patients with prior mitral valve replacement (MVR) and TAVRI patients without prior MVR Results: A total of 151 TAVI patients with prior PMV were compared with 84,204 TAVI patients without prior PMV.Propensity score matching was not performed due to rarity of the exposure group and low event rates.At 30 days, there were no significant differences in MACE (8.3% vs 6.8%; p=0.32), pacemaker implantation (9.3% vs 7.3%; p=0.41), acute limb ischemia (0% vs 0.4%; p=0.48), or new dialysis (0% vs 0.3%; p=0.50); survival was similar (91.65% vs 93.03%; p=0.50).At 1year, all-cause mortality (9.9% vs 7.4%; p=0.24),MACE (20.5% vs 17.4%; p=0.49), pacemaker implantation (10.0%vs 9.7%; p=0.91), acute limb ischemia, and dialysis remained comparable.Conclusions: Our study suggests that TAVR in patients with a PMV is feasible and doesn't significantly increase mortality or other adverse events in 30 days or 1 year.