Why the study?
To compare the outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) and surgical aortic valve replacement (SAVR) using a large US population sample.
Does transapical transcatheter aortic valve replacement improve in-hospital outcomes compared to surgical aortic valve replacement in adult patients?
Does transapical transcatheter aortic valve replacement improve in-hospital outcomes compared to surgical aortic valve replacement in adult patients?
In a large, risk-adjusted US inpatient cohort, transapical TAVR demonstrated similar in-hospital mortality to surgical aortic valve replacement, with lower bleeding risk and shorter hospital stays, though it was associated with higher mortality in patients with chronic lung disease.
TA-TAVR was associated with similar mortality but less bleeding and shorter stays versus SAVR; leaves open confirmation in randomized trials.
OBJECTIVE: To compare the outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) and surgical aortic valve replacement (SAVR) using a large US population sample. METHODS: The U.S. National Inpatient Sample was queried for all patients who underwent TA-TAVR or SAVR during the years 2016-2017. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were in-hospital stroke, pericardiocentesis, pacemaker insertion, mechanical ventilation, vascular complications, major bleeding, acute kidney injury, length of stay, and cost of hospitalization. Outcomes were modeled using multi-variable logistic regression for binary outcomes and generalized linear models for continuous outcomes. RESULTS: = 0.007). CONCLUSION: The risk-adjusted analysis showed that TA-TAVR has no advantage over SAVR except for patients with chronic lung disease where TA-TAVR has higher mortality.
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Abugroun et al. (2021) studied this question.
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