Abstract
ESRD patients are predisposed to the development of calcific aortic valve disease. Patients with ESRD were excluded from the clinical trials of TAVR, and hence long-term outcomes are not well established. We sought to describe the long-term outcomes, including incidence of structural valve degeneration (SVD) and re-intervention, in patients with ESRD undergoing TAVR at our institution. Retrospective registry of consecutive patients with ESRD who underwent TAVR for aortic stenosis at our institution (2012-present). Variables of interest included patient demographics, clinical and procedural characteristics. Outcomes assessed were in-hospital events, SVD, aortic re-intervention procedures, and standard MACE incidence at 30-days, 6-months, 1-year, and at annual follow-ups. Our study included 95 patients with ESRD who underwent TAVR. In-hospital events were notable for new permanent pacemaker placement (12.6%), cardiac arrest (5.3%), and mortality (6.3%). The long-term all-cause mortality was 47.4%, with survival time after TAVR of 596 days. The most common long-term MACE was MI (7.4%). Long-term SVD occurred in 25 cases (26.3%). Long-term re-intervention occurred in 3 cases (3.2%). In-hospital and long-term MACE were high; however, when looking at baseline STS scores, these rates were close to expected. SVD was elevated with over one-fourth of patients demonstrating some degree for degeneration; however, only 3.2% of patients required re-intervention. To the best of our knowledge, this is the only study characterizing long-term SVD and re-intervention rates in this population.
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More From: Journal of the Society for Cardiovascular Angiography & Interventions
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