Abstract 13481: Incidence of Post-Cardiac Injury Syndrome in Transcatheter and Surgical Aortic Valve Replacement

Abstract

Introduction: Cardiac procedures and surgeries can cause injury to the pericardium and result in pericarditis, termed post-cardiotomy syndrome or post-cardiac injury syndrome (PCIS). The incidence of PCIS after transcatheter aortic valve replacement (TAVR) is unknown, and the aim of the current study is to compare the incidence of PCIS in surgical versus transcatheter aortic valve replacement (SAVR, TAVR). Methods: In a single-center retrospective cohort study of randomly selected patients who had TAVR or SAVR in 2019, the primary outcome was PCIS, defined according to ESC guidelines. Pericarditis recurrence was also defined according to ESC guidelines. Due to baseline differences in SAVR and TAVR patients, propensity score matching was performed using calipers of width equal to 0.2 of the standard deviation of the logit of the propensity score. Results: Patients undergoing TAVR (n=103) were older, had higher STS-PROM scores, and generally more co-morbidities compared to patients undergoing SAVR (n=100), with the exception of atrial fibrillation (Table). Overall, 17 patients (17%) with SAVR had PCIS compared to 1 patient (1%) with TAVR (p<0.001). Ten patients (4.9%) were treated with pericarditis specific medications, of whom 7 (3.4%) received colchicine. Two patients (1.0%) developed recurrent pericarditis. In the sub-group (n=44) of propensity matched patients (Figure), 6 SAVR patients (27.3%) and no TAVR patients had PCIS. Conclusions: After TAVR, PCIS appears rare, which suggests that occult pericardial injury is uncommon. PCIS may also be less common after TAVR compared to SAVR, though larger studies are needed.