Abstract 359: Temporal Trends in Perioperative Cardiac Arrest Rates Following Transcatheter Aortic Valve Replacement

Abstract

Introduction: Transcatheter aortic valve replacement (TAVR) procedural volume has continued to increase over the past decade, coinciding with expanded indications by the Food and Drug Administration. Despite advancements in TAVR safety, serious procedure-related complications including cardiac arrest are still a concern. Aims: This study aims to investigate temporal trends of in-hospital cardiac arrest rates and clinical outcomes following TAVR. Methods: In this large-scale, retrospective cohort study, admitted patients with a primary or secondary diagnosis of nonrheumatic aortic stenosis who underwent TAVR were identified from 2016 to 2020 using the National Readmissions Database. Diagnoses and procedures were classified using the International Classification of Diseases, 10th edition codes. The primary outcome was temporal trends in the rates of cardiac arrest with cardiopulmonary resuscitation during the perioperative period. Secondary endpoints assessed annual discharge survival rates and 30-day readmissions. Results: Of 31,621 total TAVR procedures, perioperative cardiac arrest occurred in 1.8% (n = 579) of cases. Baseline characteristics are described in Table 1. No statistically significant change in perioperative cardiac arrest rates was observed from 2016 to 2020 (p = 0.674). The average annual discharge survival rate was 97.7% which did not change significantly over the 5-year study period (p = 0.551). From 2016 to 2020, 30-day readmissions decreased from 13.6% to 10.1%, respectively (p = 0.028). Conclusion: While perioperative cardiac arrest is associated with high mortality, it still remains a relatively rare complication as operators have become more experienced and valve device technology has improved. An overwhelming majority of TAVR patients are successfully being discharged with improved rates of 30-day readmissions observed over recent years, indicating potential improvements in postoperative care.