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Does the Type of Chronic Heart Failure Impact In-Hospital Outcomes for Aortic Valve Replacement Procedures?
Talha Mubashir1, John Zaki1, Sin Yeong An1
1Department of Anesthesiology, The University of Texas Health Science Center at Houston, Houston, Texas.
Texas Heart Institute Journal
|June 3, 2023
Summary
Chronic heart failure types do not significantly impact hospital mortality for patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Diastolic heart failure patients experienced shorter stays and lower costs.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Heart Failure Management
Background:
- Chronic heart failure (HF) presents in systolic, diastolic, or mixed forms, impacting patient management.
- Aortic stenosis is a common indication for aortic valve replacement procedures.
Purpose of the Study:
- To compare in-hospital outcomes of patients with different chronic heart failure types undergoing transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR).
Main Methods:
- Utilized the Nationwide Inpatient Sample database (2012-2015) to identify patients with aortic stenosis and chronic HF.
- Employed propensity score matching and multivariate logistic regression to analyze outcomes.
- Included 9,879 patients with systolic, diastolic, and mixed chronic HF.
Main Results:
- No significant differences in hospital mortality were observed across chronic HF types for TAVR or SAVR.
- Patients with diastolic HF had shorter hospital stays and lower costs.
- Systolic HF was associated with increased risks of acute myocardial infarction and cardiogenic shock, but lower risk of permanent pacemaker implantation compared to diastolic HF.
Conclusions:
- Chronic heart failure type does not appear to be a significant predictor of hospital mortality following TAVR or SAVR.
- Specific HF types are associated with differential risks for certain adverse events, guiding procedural considerations.
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