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Association Between Wait Time for Transcatheter Aortic Valve Replacement and Early Postprocedural Outcomes
Gabby Elbaz-Greener1, Brianne Yarranton1, Feng Qiu2
11 Division of Cardiology and Cardiac Surgery Schulich Heart Centre Sunnybrook Health Sciences Centre University of Toronto Ontario Canada.
Journal of the American Heart Association
|January 8, 2019
Summary
Transcatheter aortic valve replacement (TAVR) wait times do not impact postprocedural outcomes. Urgency status, not wait duration, is the key factor influencing TAVR results.
Area of Science:
- Cardiovascular Medicine
- Health Services Research
Background:
- Growing demand for transcatheter aortic valve replacement (TAVR) leads to longer wait times.
- While longer wait times are linked to adverse events before TAVR, their effect on postprocedural outcomes is unclear.
Purpose of the Study:
- To investigate the association between TAVR wait times and postprocedural mortality and readmission.
Main Methods:
- A population-based study in Ontario, Canada, analyzed 2170 TAVR procedures (2010-2016).
- Wait time was measured from referral to procedure.
- Outcomes included 30-day all-cause mortality and readmission, analyzed using nonlinear regression models.
Main Results:
- A nonlinear relationship was observed between TAVR wait time and 30-day mortality/readmission, with higher risk at shorter wait times.
- This relationship disappeared after adjusting for case urgency status.
- Sensitivity analyses for elective and urgent cases showed no association between wait time and outcomes.
Conclusions:
- TAVR wait times do not independently affect postprocedural outcomes.
- Case urgency status fully mediates the relationship between wait times and outcomes.
- Further research should identify predictors of urgent TAVR hospitalization during wait periods.
Keywords:
outcometranscatheter aortic valve implantationtranscatheter aortic valve replacementwait timeMore Related Videos
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