Direct Comparison of Outcomes After Transcatheter Aortic Valve Replacement in Veterans and Non-Veterans Using the Transcatheter Valve Therapy Registry

This study aims to compare veterans and non-veterans undergoing transcatheter aortic valve replacement (TAVR) using data from the Society for Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) registry. Patients undergoing TAVR at George Washington University...

Full description

Saved in:

Bibliographic Details
Published in:	The Journal of invasive cardiology Vol. 34; no. 8; p. E601
Main Authors:	Napolitano, Michael A, Holleran, Timothy J, Sparks, Andrew D, Morrissette, Jason R, DoCampo, Jennifer A, Mordini, Federico E, Greenberg, Michael D, Mazhari, Ramesh, Reiner, Jonathan S, Choi, Andrew D, Krepp, Joseph, Najam, Farzad, Pocock, Elizabeth S, Antevil, Jared L, Trachiotis, Gregory D, Nagy, Christian D
Format:	Journal Article
Language:	English
Published:	United States 01-08-2022
Subjects:	Aortic Valve - surgery Aortic Valve Stenosis - diagnosis Aortic Valve Stenosis - surgery Humans Registries Risk Factors Transcatheter Aortic Valve Replacement - adverse effects Treatment Outcome United States - epidemiology United States valve replacement long-term results transcatheter implantation
Online Access:	Get more information
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	This study aims to compare veterans and non-veterans undergoing transcatheter aortic valve replacement (TAVR) using data from the Society for Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) registry. Patients undergoing TAVR at George Washington University (GWU) and veterans treated at Washington DC Veterans Affairs Medical Center (VAMC) who underwent TAVR at GWU from 2014-2020 were included. All patients were reported in the TVT registry. Emergency and valve-in-valve TAVR were excluded. Cohorts were divided based on veteran status. Operators were the same for both groups. Outcomes were compared at 30 days and 1 year. The primary outcome was mortality and secondary outcomes were morbidity metrics. A total of 299 patients (91 veterans, 208 non-veterans) were included. Veterans had higher rates of hypertension (87.9% vs 77.9%; P=.04), diabetes (46.7% vs 28.9%; P<.01), and lung disease (2.4% vs 11.0%; P<.001). Outcomes were not significantly different between veterans and non-veterans, including 30-day mortality (0% vs 2.9%, respectively; P=.18), 1-year mortality (9.8% vs 10.7%, respectively; P=.61), stroke incidence (0% vs 2.5%, respectively; P=.73), median intensive care unit stay (24 hours in both groups), and overall hospital stay (2 days in both groups). The affiliation between a VAMC and an academic medical center allowed for direct comparison between veterans and non-veterans undergoing TAVR by the same operators using the TVT registry. Despite significantly higher rates of comorbidities, veterans had equivalent outcomes compared with non-veterans. This may be in part due to the comprehensive care that veterans receive in the VAMC and this institution's integrated heart center team.
ISSN:	1557-2501
DOI:	10.25270/jic/21.00377