Wait time impact on prognosis for patients awaiting an aortic valve replacement

The only effective treatment for severe aortic stenosis (AS) is aortic valve replacement (AVR). The intervention should happen as soon as possible to lower the risk of heart failure and death. We aimed to assess the time between referral to the surgery center and performing the AVR for a sample of patients with severe AS diagnosis, as well as the impact it may have on hospitalization and mortality.

This was a retrospective study including 241 patients with severe AS submitted to AVR at the surgery center between January 2018 and December 2021, or patients that died during that period.

In a total of 174 ambulatory patients who underwent AVR, 82.2% had surgical aortic valve replacement (SAVR) and 17.8% transcatheter aortic valve implantation (TAVI). The median wait time for SAVR and TAVI was 226 and 426 days, respectively. From a total of 56 hospitalized patients who underwent AVR, 89.3% had SAVR and 10.7% TAVI. The mean wait time for SAVR and TAVI was 9 and 15 days, respectively. While waiting for intervention, 13% of patients were hospitalized and 6% died.

The wait times for AVR found in our study are substantially longer than recommended for outpatient regimen. Extended wait times are linked to an increasing incidence of adverse events.