Abstract 13049: Peripheral Artery Disease In Patients Undergoing Transcatheter Aortic Valve Replacement In Northern New England

Abstract

Background: Transcatheter aortic valve replacement (TAVR) is now more common than surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. In the general population, the prevalence of peripheral artery disease (PAD) in patients undergoing transfemoral TAVR is 25%, with higher risk of adverse outcomes including bleeding, readmission, myocardial infarction, and all-cause mortality. The objective of this study was to examine the prevalence of peripheral artery disease in patients undergoing TAVR at Dartmouth-Hitchcock Medical Center (DHMC). Methods: We performed a retrospective observational study of 569 patients undergoing TAVR between 1/1/2012-4/8/2020. PAD was defined as presence of aorto-iliac, femoral-popliteal, below-knee tibial, reno-vascular, mesenteric, cerebrovascular, aortic disease, or upper extremity arterial disease noted in the patient’s chart prior to TAVR. Results: Of 569 TAVR patients, 19% (n=109) had concomitant PAD. Of these, 70 patients (64%) were established with a vascular specialist and 54 (50%) had a prior intervention relating to their disease. Figure 1 characterizes the distribution and location of PAD among patients. Conclusion: In a Northern New England population, 1 in 5 patients undergoing TAVR had concomitant PAD. Cerebrovascular and peripheral vascular disease were most common. Understanding PAD epidemiology is of paramount importance with respect to vascular access and longitudinal management in a vulnerable aortic stenosis population.