Outcomes of Transthoracic Aortic Valve Replacement Among Patients with Hypertrophic Cardiomyopathy
Document Type
Article
Abstract
Background: Although not systematically studied, concerns have been raised regarding abrupt decrease in afterload resulting in dynamic outflow tract obstruction and hemodynamic collapse following transcatheter aortic valve replacement (TAVR) in patients with hypertrophic cardiomyopathy (HCM). We aimed to compare in-hospital outcomes of TAVR in patients with severe aortic valve stenosis with and without a diagnosis of HCM.
Methods: National Inpatient Sample 2016-2019 was used to identify and group TAVR cases into those with and without a diagnosis of HCM. Logistic regression was used to compare baseline characteristics and in-hospital outcomes.
Results: From 2016-2019, a total of 180,740 patients underwent TAVR with 710 (0.4%) patients having a concurrent diagnosis of HCM (56% designated as obstructive). Patients with HCM were more often female (65%-vs-45%, 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 (2.82% vs. 1.29%, p<0.001), cardiogenic shock (7.04% vs. 2.06%, p<0.001), and admission to the ICU (7.75% vs. 4.77%, p<0.001).
Conclusion: TAVR 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 TAVR.
First Page
999
DOI
10.1016/S0735-1097(24)02989-9
Publication Date
4-2-2024
Recommended Citation
Roma N, Desai S, Shah K, Krinock M, Shirani J. OUTCOMES OF TRANSTHORACIC AORTIC VALVE REPLACEMENT AMONG PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY. Journal of the American College of Cardiology. 2024 Apr 2;83(13_Supplement):999-.