Surgical Aortic Valve Replacement in Patients with Hypertrophic Cardiomyopathy
Document Type
Article
Abstract
Background: Surgical aortic valve replacement (SAVR) improves survival in severe symptomatic aortic valve stenosis (class I indication). Patients with hypertrophic cardiomyopathy (HCM) have been excluded from pivotal randomized controlled trials of SAVR. SAVR is also recommended for moderate aortic stenosis in patients who undergo cardiac surgery for other reasons such as surgical myectomy for (HCM). We aimed to evaluate in-hospital outcomes of SAVR in HCM.
Methods: National Inpatient Sample was queried from 2016-2019.
Results: National Inpatient Sample contained 252,110 patients who underwent SAVR between 2016-2019. Of these, 2650 (1.05%) had a concurrent diagnosis of HCM (61% obstructive, 32% concomitant myectomy). Patients with HCM were more often female (53%-vs-32%, p<0.001) and had lower overall prevalence of comorbid conditions (Table). However, in-hospital outcomes were significantly worse in HCM than non-HCM patients (Table), including mortality (8.3 vs. 3.4%, p<0.001), cardiogenic shock (9.8% vs. 7.6%, p<0.001), vasopressor use (10.02% vs. 6.73%, p<0.001) and admission to the ICU (21.2% vs. 15.7%, p<0.001).
Conclusion: SAVR in patients with HCM is associated with higher complication rates compared to patients with valvular aortic stenosis and no HCM. Length of hospital stay and hospital cost is also higher in those with HCM undergoing SAVR.
First Page
2178
DOI
10.1016/S0735-1097(24)04168-8
Publication Date
4-2-2024
Recommended Citation
Roma N, Desai S, Shah K, Krinock M, Shirani J. SURGICAL AORTIC VALVE REPLACEMENT IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY. Journal of the American College of Cardiology. 2024 Apr 2;83(13_Supplement):2178-.