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Transcatheter Aortic Valve Replacement

Abstract

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A prospective, randomised trial of transapical transcatheter aortic valve implantation vs. surgical aortic valve replacement in operable elderly patients with aortic stenosis: the STACCATO trial 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines The Year in Cardiovascular Medicine 2020: Valvular Heart Disease: Discussing the Year in Cardiovascular Medicine for 2020 in the field of valvular heart disease is Professor Helmut Baumgartner and Dr Javier Bermejo. Mark Nicholls reports Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement Is Not Associated With Increased Early or Late Readmission Risk Comparison of Safety and Periprocedural Complications of Transfemoral Aortic Valve Replacement Under Local Anaesthesia: Minimalist Versus Complete Heart Team Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort Transcatheter aortic-valve replacement with a self-expanding prosthesis Predictors and Clinical Outcomes of Next-Day Discharge After Minimalist Transfemoral Transcatheter Aortic Valve Replacement
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Original Research2020 Jan 20;S0828-282X(20)30043-X.

JOURNAL：Can J Cardiol . Article Link

Comparison of 1-Year Pre- And Post-Transcatheter Aortic Valve Replacement Hospitalization Rates: A Population-Based Cohort Study

A Czarnecki, F Qiu, KA Henning et al. Keywords: hospitalization rates pre- and postprocedure; TAVR

ABSTRACT

BACKGROUND - Rehospitalization rates post-transcatheter aortic valve replacement (TAVR) are high; however, it is not known how these compare with pre-TAVR hospitalization rates. Our objective was to determine the association between the index TAVR and hospitalization rates pre- and postprocedure.


METHODS - A retrospective observational study was performed including all TAVR procedures performed in Ontario, Canada, between 2013 and 2017. Patients who died during the index hospitalization were excluded. The primary outcome was all-cause hospitalization within 1 year of TAVR discharge. Hospitalization rates per person-year were calculated and compared for each of the following analogous time periods pre- and post-index TAVR: 1 to 30, 31 to 90, 91 to 365, and 1 to 365 days. Poisson regression models were used to generate rate ratios to compare hospitalization rates.


RESULTS - The final study cohort included 2547 patients. In the year before TAVR, 60.2% of patients were hospitalized, compared with 45.9% in the year following the procedure. The rate ratio (RR) for the year post-TAVR compared with pre-TAVR was 0.82 (95% confidence interval [CI], 0.77- 0.88). When comparing each parallel time period post- vs pre-TAVR, all intervals were associated with significant reductions in hospitalization after TAVR, except the 30-day periprocedural period. The largest change in hospitalization rates occurred in the 31 to 90 days post- vs the corresponding period pre-TAVR (RR: 0.57; 95% CI, 0.50-0.64) CONCLUSION: TAVR is associated with a significant and sustained reduction in all-cause hospitalization in the year following the procedure compared with the preprocedural period.


Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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