Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes

Background: Bicuspid aortic valve (BAV) disease is considered the most common congenital heart disease and the main etiology of aortic valve stenosis (AS) in young adults. Although transcatheter aortic valve replacement (TAVR) is routinely used in high- and intermediate-risk patients with AS, BAV pa...

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Autores principales:	Mohamad Soud, Yasser Al-khadra, Fahed Darmoch, Homam Moussa Pacha, Zaher Fanari, M Chadi Alraies
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2020
Materias:	bicuspid aortic valve stenosis surgical aortic valve replacement transcatheter aortic valve replacement Medicine R
Acceso en línea:	https://doaj.org/article/bd1ce2a9eda04102bd93f659aa2e1f09
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spelling	oai:doaj.org-article:bd1ce2a9eda04102bd93f659aa2e1f092021-12-02T15:06:48ZTranscatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes2231-07702249-446410.4103/ajm.ajm_134_19https://doaj.org/article/bd1ce2a9eda04102bd93f659aa2e1f092020-01-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/ajm.ajm_134_19https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Background: Bicuspid aortic valve (BAV) disease is considered the most common congenital heart disease and the main etiology of aortic valve stenosis (AS) in young adults. Although transcatheter aortic valve replacement (TAVR) is routinely used in high- and intermediate-risk patients with AS, BAV patients with AS were excluded from all pivotal trials that led to TAVR approval. We sought, therefore, to examine in-hospital outcomes of patients with BAV who underwent TAVR in comparison with surgical aortic valve replacement (SAVR). Methods: Using the National Inpatient Sample from 2011 to 2014, we identified patients with BAV with International Classification of Diseases-Ninth Revision-CM code 746.4. Patients who underwent TAVR were identified using ICD-9 codes 35.05 and 35.06 and those who underwent SAVR were identified using codes 35.21 and 35.22 during the same period. Results: A total of 37,052 patients were found to have BAV stenosis. Among them, 36,629 patients (98.8%) underwent SAVR, whereas 423 patients (1.14%) underwent TAVR. One-third of enrolled patients were female, and the majority of the patients were White with a mean age of 65.9 ± 15.1 years. TAVR use for BAV stenosis significantly increased from 0.39% in 2011 to 4.16% in 2014 (P < 0.001), which represents a 3.77% overall growth in procedure rate. The median length of stay decreased significantly throughout the study period (mean 12.2 ± 8.2 days to 7.1 ± 5.9 days, P < 0.001). There was no statistically significant difference between SAVR and TAVR groups in the in-hospital mortality (0% vs. 5.9%; adjusted P = 0.119). Conclusion: There is a steady increase in TAVR use for BAV stenosis patients along with a significant decrease in length of stay.Mohamad SoudYasser Al-khadraFahed DarmochHomam Moussa PachaZaher FanariM Chadi AlraiesThieme Medical and Scientific Publishers Pvt. Ltd.articlebicuspid aortic valve stenosissurgical aortic valve replacementtranscatheter aortic valve replacementMedicineRENAvicenna Journal of Medicine, Vol 10, Iss 01, Pp 22-28 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	bicuspid aortic valve stenosis surgical aortic valve replacement transcatheter aortic valve replacement Medicine R
spellingShingle	bicuspid aortic valve stenosis surgical aortic valve replacement transcatheter aortic valve replacement Medicine R Mohamad Soud Yasser Al-khadra Fahed Darmoch Homam Moussa Pacha Zaher Fanari M Chadi Alraies Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes
description	Background: Bicuspid aortic valve (BAV) disease is considered the most common congenital heart disease and the main etiology of aortic valve stenosis (AS) in young adults. Although transcatheter aortic valve replacement (TAVR) is routinely used in high- and intermediate-risk patients with AS, BAV patients with AS were excluded from all pivotal trials that led to TAVR approval. We sought, therefore, to examine in-hospital outcomes of patients with BAV who underwent TAVR in comparison with surgical aortic valve replacement (SAVR). Methods: Using the National Inpatient Sample from 2011 to 2014, we identified patients with BAV with International Classification of Diseases-Ninth Revision-CM code 746.4. Patients who underwent TAVR were identified using ICD-9 codes 35.05 and 35.06 and those who underwent SAVR were identified using codes 35.21 and 35.22 during the same period. Results: A total of 37,052 patients were found to have BAV stenosis. Among them, 36,629 patients (98.8%) underwent SAVR, whereas 423 patients (1.14%) underwent TAVR. One-third of enrolled patients were female, and the majority of the patients were White with a mean age of 65.9 ± 15.1 years. TAVR use for BAV stenosis significantly increased from 0.39% in 2011 to 4.16% in 2014 (P < 0.001), which represents a 3.77% overall growth in procedure rate. The median length of stay decreased significantly throughout the study period (mean 12.2 ± 8.2 days to 7.1 ± 5.9 days, P < 0.001). There was no statistically significant difference between SAVR and TAVR groups in the in-hospital mortality (0% vs. 5.9%; adjusted P = 0.119). Conclusion: There is a steady increase in TAVR use for BAV stenosis patients along with a significant decrease in length of stay.
format	article
author	Mohamad Soud Yasser Al-khadra Fahed Darmoch Homam Moussa Pacha Zaher Fanari M Chadi Alraies
author_facet	Mohamad Soud Yasser Al-khadra Fahed Darmoch Homam Moussa Pacha Zaher Fanari M Chadi Alraies
author_sort	Mohamad Soud
title	Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes
title_short	Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes
title_full	Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes
title_fullStr	Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes
title_full_unstemmed	Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes
title_sort	transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2020
url	https://doaj.org/article/bd1ce2a9eda04102bd93f659aa2e1f09
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Transcatheter aortic valve replacement in patients with bicuspid aortic valve stenosis: national trends and in-hospital outcomes

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