Abstract P183: Systolic Dysfunction is Associated With Increased Occurrence and Worse Outcomes of Periprocedural Cardiovascular Adverse Events After Transcatheter Aortic Valve Replacement

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Background: Transcatheter aortic valve replacement (TAVR) rate continues to ascend nationwide as per the transcatheter valve therapy registry, and this calls for even better strategies to aim for negligible complication rates. Current practice relies on surgically derived risk models. We set out to assess the impact of systolic dysfunction on perioperative cardiovascular adverse events. Hypothesis: The presence of systolic dysfunction is associated with increased frequency and poorer outcomes of periprocedural cardiovascular adverse events among patients undergoing TAVR. Method: A retrospective cohort study was designed using data obtained from the 2016 to 2018 combined National Inpatient Sample (NIS) database. The current procedural terminology (CPT) Codes of ICD-10 were used to identify patients admitted for TAVR. They were then dichotomized into two cohorts based on the presence of systolic dysfunction. Primary outcomes were death, length of stay, total charge, composite of all cardiovascular perioperative adverse events and composite of all cardiovascular perioperative adverse events and death. Secondary outcomes were individual cardiovascular perioperative adverse events for all TAVR admissions and subsequently for patients with post-TAVR cardiac dysfunction. Multivariate linear and logistic regressions were used to adjust for confounders. Results: There was a total of 145,640 admissions for TAVR among whom were 16,980 with systolic dysfunction. Details of outcomes of study are summarized in table 1 below. Conclusion: Among inpatients who underwent TAVR, systolic dysfunction is associated with higher odds of mortality, composite of all cardiovascular adverse events and composite of death and all cardiovascular adverse events. There was increased odds of periprocedural cardiac dysfunction, particularly with increased cardiogenic shock. There was increased length of stay and total charge.