Long term mortality and readmissions after transcatheter aortic valve replacement

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Health Services Research

Background:

• Transcatheter aortic valve replacement (TAVR) is increasingly common, yet detailed data on long-term readmissions beyond 30 days are limited.
• Understanding readmission patterns to various care levels is crucial for improving patient outcomes after TAVR.

Purpose of the Study:

• To analyze the incidence, causes, and outcomes of cardiac and non-cardiac inpatient readmissions following TAVR up to three years post-procedure.
• To investigate the impact of readmission to different care levels (ICU vs. non-ICU) on mortality in TAVR patients.

Main Methods:

• Retrospective chart review of 1,037 consecutive TAVR patients (2011-2017).
• Readmissions were classified by primary diagnosis (cardiac vs. non-cardiac) and care level (ICU vs. non-ICU).
• Evaluation of readmission incidence, causes, and outcomes up to three years post-TAVR.

Main Results:

• Non-cardiac readmissions (34.4%) were more frequent than cardiac (20.5%) in 1,017 surviving patients.
• Common non-cardiac causes included sepsis/infection; cardiac causes included heart failure.
• Readmission to the ICU (18.8%) was associated with markedly increased mortality.

Conclusions:

• Non-cardiac readmissions are more prevalent than cardiac in TAVR survivors.
• The highest risk for readmission and mortality occurs immediately post-TAVR.
• Baseline comorbidities significantly influence readmission risk and outcomes in TAVR patients.