PMID- 35562299 OWN - NLM STAT- MEDLINE DCOM- 20220615 LR - 20220629 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 175 DP - 2022 Jul 15 TI - Comparison of In-Hospital Outcomes and Readmission Rates of Transcatheter Aortic Valve Implantation in Mixed Aortic Valve Disease Versus Pure Aortic Stenosis. PG - 72-79 LID - S0002-9149(22)00404-0 [pii] LID - 10.1016/j.amjcard.2022.03.052 [doi] AB - Recently, transcatheter aortic valve implantation (TAVI) has been performed in patients with combined aortic stenosis (AS) and aortic regurgitation. We sought to evaluate in-hospital outcomes and readmission rates after TAVI in patients with mixed aortic valve disease (MAVD). A total of 100,573 TAVI procedures were identified between 2011 and 2017 using International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision procedure codes the from Nationwide Readmissions Database. We separated patients into 2 cohorts, those with MAVD and those with pure AS. The primary outcome was all-cause inpatient mortality after TAVI, and secondary outcomes included rates of 30- and 90-day readmissions and postprocedural complications. A total of 3,260 patients had MAVD (median age 83 years, 43.5% women). In-hospital mortality (2.5% vs 2.6%, p = 0.531) and rates of paravalvular leak (1.0% vs 1.3%, p = 0.056) were similar between the MAVD and pure AS groups. Major bleeding (7.4% vs 9.6%, p <0.001), 30-day readmission (0.5% vs 8.8%, p <0.001) and 90-day readmission rates (0.8% vs 16.0%, p <0.001), acute kidney injury (12.9% vs 15.1%, p <0.001), postoperative ischemic stroke (2.0% vs 5.7%, p <0.001), and mechanic circulatory support use (1.9% vs 4.5%, p <0.001) were less prevalent in the MAVD cohort. Using a multivariate logistic regression model to adjust for confounding factors, MAVD was not predictive of mortality in patients who underwent TAVI (adjusted odds ratio [adjOR] 1.25, 95% confidence interval [CI] 0.99 to 1.57, p = 0.056); however, MAVD was associated with: decreased odds of 30-day readmission (adjOR 0.05, 95% CI 0.03 to 0.08, p <0.001), 90-day readmission rates (adjOR 0.04, 95% CI 0.03 to 0.06, p <0.001), and higher odds of pacemaker implantation (adjOR 1.46, 95% CI 1.29 to 1.65, p <0.001). In conclusion, despite differences in the aortic valve and left ventricular anatomy (pressure vs volume-related adaptive changes) in patients with MAVD and pure AS, TAVI appears safe and feasible. However, patients with MAVD were more likely to have permanent pacemakers implanted. The results of our study warrant further randomized controlled studies to confirm these findings. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Grant, Jelani K AU - Grant JK AD - XXX, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida; University of Miami Leonard M. Miller School of Medicine, Miami, Florida. Electronic address: jelani.grant@jhsmiami.org. FAU - Rubin, Phillip AU - Rubin P AD - XXX, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida; University of Miami Leonard M. Miller School of Medicine, Miami, Florida. FAU - Chambers, Sharde AU - Chambers S AD - XXX, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida; University of Miami Leonard M. Miller School of Medicine, Miami, Florida. FAU - Dangl, Michael AU - Dangl M AD - XXX, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida; University of Miami Leonard M. Miller School of Medicine, Miami, Florida. FAU - Vincent, Louis AU - Vincent L AD - XXX, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida; University of Miami Leonard M. Miller School of Medicine, Miami, Florida. FAU - Ebner, Bertrand AU - Ebner B AD - XXX, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida; University of Miami Leonard M. Miller School of Medicine, Miami, Florida. FAU - Maning, Jennifer AU - Maning J AD - XXX, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida; University of Miami Leonard M. Miller School of Medicine, Miami, Florida. FAU - Olorunfemi, Odunayo AU - Olorunfemi O AD - University of Miami Leonard M. Miller School of Medicine, Miami, Florida; Cardiovascular Division, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida. FAU - Colombo, Rosario AU - Colombo R AD - University of Miami Leonard M. Miller School of Medicine, Miami, Florida; Cardiovascular Division, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida. FAU - Braghiroli, Joao AU - Braghiroli J AD - University of Miami Leonard M. Miller School of Medicine, Miami, Florida; Cardiovascular Division, Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida. LA - eng PT - Journal Article DEP - 20220511 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged, 80 and over MH - Aortic Valve/surgery MH - *Aortic Valve Stenosis/complications MH - Female MH - *Heart Valve Prosthesis Implantation/methods MH - Hospitals MH - Humans MH - Male MH - Patient Readmission MH - Postoperative Complications/epidemiology/surgery MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/methods MH - Treatment Outcome EDAT- 2022/05/14 06:00 MHDA- 2022/06/16 06:00 CRDT- 2022/05/13 22:13 PHST- 2022/01/07 00:00 [received] PHST- 2022/03/21 00:00 [revised] PHST- 2022/03/23 00:00 [accepted] PHST- 2022/05/14 06:00 [pubmed] PHST- 2022/06/16 06:00 [medline] PHST- 2022/05/13 22:13 [entrez] AID - S0002-9149(22)00404-0 [pii] AID - 10.1016/j.amjcard.2022.03.052 [doi] PST - ppublish SO - Am J Cardiol. 2022 Jul 15;175:72-79. doi: 10.1016/j.amjcard.2022.03.052. Epub 2022 May 11.