Abstract 11181: Transfemoral Transcatheter Aortic Valve Replacement in the Catheterization Lab vs the Operating Room

Abstract

Introduction: Within the past decade, transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of calcific aortic stenosis across the surgical risk spectrum. With increasing volumes of procedures, there has a shift in TAVRs into the cardiac catheterization lab and out of the hybrid operating room. A better understanding is needed regarding the impact this has on procedural success and outcomes. Methods: Patients undergoing transfemoral TAVR between April 2016 and April 2019 at the University of North Carolina were included retrospectively. Unpaired t-test, Fisher’s exact test, and chi square analysis were used to compare procedure characteristics and outcomes performed in the catheterization lab to TAVR performed in the OR. Results: A total of 160 transfemoral TAVRs were performed in the catheterization lab while 119 were performed in the OR. There were no significant differences in baseline or comorbidity characteristics. Table 1 includes data analysis finding no significant difference in procedure time, contrast volume, fluoroscopy time, anesthesia type, aborted procedures, conversions to open surgery, paravalvular leak, endocarditis, stroke, KCCQ-12 difference at 4-7 week follow up, and one year mortality. Figure 1 includes the location of transcatheter TAVR procedures at UNC over time. Conclusions: Transfemoral TAVR performed in the catheterization lab is as safe and efficacious as TAVR performed in the OR. This has significant implications for resource utilization, ability to expand this therapy, and the costs associated with TAVR.