In-Hospital Outcomes of Transcatheter Aortic Valve Implantation in Patients With Mitral Valve Stenosis

Abstract

Little is known about the outcome of patients with mitral stenosis (MS) who underwent transcatheter aortic valve implantation (TAVI). Therefore, we sought to evaluate the potential impact of MS on the outcome of patients who underwent TAVI using the US national cohort. Using weighted data from the National Inpatient Sample database between 2011 and 2015, we identified patients who had undergone a TAVI as a primary procedure. Patients with MS diagnosis were compared with those without MS. Univariate and multivariate logistic regression analyses were performed for the outcomes of in-hospital mortality and postprocedural complications. Outcomes were also stratified by the type to TAVI (endovascular vs transapical). A total of 62,110 patients underwent TAVI (mean age 81 ± 8.72, 47.4% females, and 3.7% African-Americans) and 887 patients had MS (1.43%). Patients with concomitant MS had higher in-hospital mortality (5.1% vs 3.5% adjusted odds ratio [aOR] 1.455; 95% confidence interval [CI] 1.059 to 2.001, p = 0.021), major adverse cardiac events (9.0% vs 7.1% aOR 1.297; 95% CI 1.012 to 1.663, p = 0.040), major bleeding (16.3% vs 12.1% aOR 1.303; 95% CI 1.067 to 1.593, p = 0.010), cardiac complications (21.8% vs 16.0% aOR 1.536; 95% CI, 1.300 to 1.815, p < 0.001), and acute myocardial infarction (4.5% vs 2.8% aOR 1.783; 95% CI 1.249 to 2.545, p = 0.007) when compared with patients without MS. In conclusion, MS is an independent risk factor for mortality and morbidity after TAVI procedure for patients with severe aortic stenosis.