Abstract
Introduction: Chronic Liver Disease (CLD) patients are known to have increased morbidity and mortality when undergoing surgical procedures. While short term outcomes among patients undergoing transcatheter (TAVR) or surgical aortic valve replacement (SAVR) have been studied, research assessing long term outcomes are scant. Therefore, the goal was to assess 5-year complications among CLD patients undergoing TAVR or SAVR. Methods: A retrospective cohort study was done using TriNetX, a national federated real time database of 69 million records. Patient cohorts were identified if they met the criteria for CLD and underwent TAVR or SAVR up until May 2016 for 5 year follow up. An 1:1 matched propensity score analysis was conducted, adjusting for comorbidities and demographics, to calculate adjusted Risk Ratios (aRR) with 95% confidence intervals (CI) for complications of interest. Kaplan Meir (KM) analysis was done to calculate survival probability in 5 years among the 2 cohorts. Results: In a matched sample of 268 patients in each cohort, the TAVR group showed higher 5-year mortality (RR[CI]): (1.34[1.04-1.73]) compared to the SAVR Group. KM analysis also revealed a significantly lower survival probability in TAVR group (purple) compared to the SAVR group (green) (p<0.001).There were no statistically significant differences among the 2 cohorts in other assessed long-term complications such as stroke (0.66[0.39-1.1]), new pacemaker placement (0.85[0.49-1.44]), and redo TAVR/SAVR (1.3[0.58-2.9]). Conclusions: In CLD patients, there is a higher risk of mortality for patients undergoing TAVR vs SAVR. All other assessed complications revealed no significant difference. Additional research is needed to visit further longer-term impacts in CLD patients.
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