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Clinical Outcomes Post-Transcatheter Aortic Valve Replacement in Patients With Hypertrophic Obstructive

Muhammad Usman Almani1, Vibhor Ahluwalia2, Muhammad Yousuf3

  • 1Division of Cardiology, Jefferson Einstein Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 24, 2025
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) in patients with hypertrophic obstructive cardiomyopathy (HOCM) is associated with a significantly higher risk of in-hospital mortality. However, readmission outcomes were similar between HOCM and non-HOCM patients post-TAVR.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) patients were historically excluded from transcatheter aortic valve replacement (TAVR) trials.
  • Post-TAVR "suicide left ventricle" is a concern due to potential worsening of left ventricular outflow tract obstruction.

Purpose of the Study:

  • To evaluate clinical and readmission outcomes for HOCM patients undergoing TAVR.
  • To compare outcomes between TAVR patients with and without comorbid HOCM.

Main Methods:

  • Utilized data from the National Inpatient and National Readmission Databases (2016-2020).
  • Performed multivariable logistic regression for in-hospital mortality and clinical outcomes.
  • Employed multivariable Cox regression for 30-day readmission assessment.

Main Results:

  • Identified 534 HOCM patients (0.2%) among 296,670 TAVR cases.
  • HOCM patients had a >3-fold increased risk of in-hospital mortality (aOR: 3.47).
  • HOCM patients experienced higher rates of atrioventricular blocks, cardiogenic shock, acute kidney injury, and intubation; no difference in readmissions.

Conclusions:

  • TAVR in HOCM patients is linked to significantly higher in-hospital mortality.
  • Patients with HOCM face increased procedural complications during TAVR.
  • Real-world data indicates elevated risks for HOCM patients undergoing TAVR.
Abstract

Keywords:
hypertrophic obstructive cardiomyopathysuicide left ventricletranscatheter aortic valve replacement

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