Prevalence and Clinical Outcomes of Noncardiac Surgery After Transcatheter Aortic Valve Replacement

Abstract

BackgroundAortic stenosis (AS) is a prevalent valvular heart disease, especially among the elderly. They often coexist with other comorbidities, and noncardiac surgery carries a higher risk due to the underlying valve condition. Despite the growing concern about the safety and optimal management of non-cardiac surgery post-transcatheter aortic valve replacement (TAVR), there is limited evidence on this matter. This study aims to assess the clinical outcomes of non-cardiac surgeries following TAVR. Methods and ResultsThis retrospective study included 718 patients who underwent TAVR. Of these, 36 patients underwent non-cardiac surgery after TAVR. The primary endpoint was the incidence of cardiovascular adverse events post-TAVR and the secondary endpoint was the incidence of structural valve deterioration (SVD). Composite endpoints included disabling stroke, heart failure requiring hospitalization, and cardiac death as defined by VARC3. Most of these surgeries were orthopedic and classified as intermediate risk. All non-cardiac surgeries were performed without perioperative adverse events. There was no observed SVD, and the incidence of composite endpoints did not significantly differ between the surgical and non-surgical groups during the follow-up period. ConclusionNon-cardiac surgery after TAVR can be performed safely and does not have a negative impact on prognosis. Further studies are warranted to determine the optimal strategy for non-cardiac surgery post-TAVR.