In-hospital outcomes of non-elective transapical transcatheter versus surgical aortic valve replacement.

IF 3.9 2区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES
Renxi Li, Deyanira J Prastein, Steven W Boyce, Brian G Choi
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引用次数: 0

Abstract

When transfemoral (TF) access is not available during transcatheter aortic valve replacement (TAVR), transapical (TA)-TAVR can be performed. However, TA-TAVR is associated with significantly higher risk, and it is unclear whether it provides more benefit than surgical aortic valve replacement (SAVR) in non-elective cases. This study aimed to compare the in-hospital outcomes of non-elective TA-TAVR and SAVR by conducting a population-based analysis using a national registry. Patients who underwent non-elective TA-TAVR and SAVR were selected from National Inpatient Sample from Q4 2015 to 2021. Exclusion criteria included age < 18 years and concomitant procedures. Demographics, socioeconomic status, comorbidities, relevant diagnosis, transfer-in status, and hospital characteristics were matched between patients who underwent TA-TAVR and SAVR using a 1:3 propensity-score matching. In-hospital outcomes were compared. There were 130 and 10,487 patients who underwent TA-TAVR and SAVR, respectively. After the propensity-score matching, all TA-TAVR patients were matched to 341 SAVR patients. TA-TAVR and SAVR patients had comparable in-hospital mortality (7.69% vs. 7.33%, p = 0.85), myocardial infarction (3.85% vs. 4.4%, p = 1.00), stroke (0.77% vs. 1.76%, p = 0.69), respiratory complications (15.38% vs. 17.6%, p = 0.68), cardiogenic shock (14.62% vs. 12.61%, p = 0.55), and pacemaker implantation (10% vs. 7.33%, p = 0.35). However, TA-TAVR patients had lower hemorrhage/hematoma (38.46% vs. 68.33%, p < 0.01), lower transfer out rate (33.08% vs. 44.87%, p = 0.02), and shorter length of stay (p = 0.04). All other in-hospital outcomes were comparable. Among eligible TAVR candidates in non-elective cases and when TF access is not available, both TA-TAVR and SAVR may be equally alternative approaches considering their comparable in-hospital outcomes. Further studies should compare the long-term outcomes between TA-TAVR and SAVR.

非选择性经根尖导管与外科主动脉瓣置换术的住院结果。
在经导管主动脉瓣置换术(TAVR)中,当经股(TF)通道不可用时,可以进行经根尖(TA)-TAVR。然而,TA-TAVR与明显更高的风险相关,并且尚不清楚在非选择性病例中,TA-TAVR是否比手术主动脉瓣置换术(SAVR)提供更多的益处。本研究旨在通过使用国家登记处进行基于人群的分析,比较非选择性TA-TAVR和SAVR的住院结果。从2015年第四季度至2021年全国住院患者样本中选择非选择性TA-TAVR和SAVR患者。排除标准包括年龄
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来源期刊
Scientific Reports
Scientific Reports Natural Science Disciplines-
CiteScore
7.50
自引率
4.30%
发文量
19567
审稿时长
3.9 months
期刊介绍: We publish original research from all areas of the natural sciences, psychology, medicine and engineering. You can learn more about what we publish by browsing our specific scientific subject areas below or explore Scientific Reports by browsing all articles and collections. Scientific Reports has a 2-year impact factor: 4.380 (2021), and is the 6th most-cited journal in the world, with more than 540,000 citations in 2020 (Clarivate Analytics, 2021). •Engineering Engineering covers all aspects of engineering, technology, and applied science. It plays a crucial role in the development of technologies to address some of the world''s biggest challenges, helping to save lives and improve the way we live. •Physical sciences Physical sciences are those academic disciplines that aim to uncover the underlying laws of nature — often written in the language of mathematics. It is a collective term for areas of study including astronomy, chemistry, materials science and physics. •Earth and environmental sciences Earth and environmental sciences cover all aspects of Earth and planetary science and broadly encompass solid Earth processes, surface and atmospheric dynamics, Earth system history, climate and climate change, marine and freshwater systems, and ecology. It also considers the interactions between humans and these systems. •Biological sciences Biological sciences encompass all the divisions of natural sciences examining various aspects of vital processes. The concept includes anatomy, physiology, cell biology, biochemistry and biophysics, and covers all organisms from microorganisms, animals to plants. •Health sciences The health sciences study health, disease and healthcare. This field of study aims to develop knowledge, interventions and technology for use in healthcare to improve the treatment of patients.
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