Abstract 13389: Outcomes of Transcatheter Aortic Valve Replacement in Patients With Prior Mediastinal Radiation in the United States

Abstract

Introduction: Although prior mediastinal radiation is associated with significantly worse clinical outcomes after SAVR, it is unknown if the same holds true for patients undergoing transcatheter aortic valve replacement (TAVR). Hypothesis: We hypothesized that the presence of prior mediastinal radiation may affect the outcomes of patients undergoing TAVR and tested this hypothesis using data from a nationally representative sample of the US population. Methods: The National Readmissions Database was analyzed from 2016-2019 to identify patients ≥ 18 years old undergoing TAVR. Patients with prior mediastinal radiation were then identified by using ICD-10 CM codes. Propensity score matching was used to adjust for confounders. Results: Our cohort included 173,743 patients undergoing TAVR, of which 2,780 (1.6%) had prior mediastinal radiation. Patients with prior mediastinal radiation undergoing TAVR were younger, had a higher proportion of females, and had a lower burden of comorbidities including hypertension, diabetes, and renal failure. Crude percentages are reported in Figure 1. On propensity score-matched analysis, the presence of prior mediastinal radiation was associated with similar odds of in-hospital mortality and peri-procedural complications including cardiovascular complications, peripheral vascular complications, pulmonary complications, neurological complications, major bleeding, and new pacemaker implantation along with similar odds of 30-day and 180-day all-cause, stroke-related, bleeding-related, and heart failure-related readmissions compared to those without prior mediastinal radiation. Conclusion: In conclusion, our data suggest that patients with prior mediastinal radiation undergoing TAVR have similar outcomes compared to those who have no history of mediastinal radiation.