DOI: 10.1161/circ.148.suppl_1.18918 ISSN: 0009-7322

Abstract 18918: Outcomes of Patients With Transcatheter Aortic Valve Replacement (TAVR) and Cardiac Resynchronization Therapy (CRT): A Retrospective Analysis

Rohan Umrani, Martin Matsumura, Trinava Roy, Neethi Dasu, Kirti Dasu
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Introduction: Many patients with TAVR have a pre-existing reduced LVEF <35% and left bundle branch block (LBBB) requiring CRT-D for potential improvement in LV function and secondary prevention of sudden death. Few studies have examined patient outcomes in this specific subpopulation. The aim of our study was to see if this patient population had worse outcomes compared to patients with TAVR without CRT-D.

Hypothesis: We hypothesized that patients undergoing CRT would have better outcomes.

Methods: Patients aged >18 years with TAVR and CRT versus TAVR alone were identified from the United States National Inpatient Sample (2015-2020). ICD 9 and 10 codes were utilized and multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, average length of stay (LOS), and hospital charges (TOTHC), after adjusting for age, gender, race, insurance, and hospital demographics (type, size, region, and teaching status). Propensity matching was performed using the Kernel method. Weighted analysis utilizing Stata 17 MP was performed.

Results: This study identified approximately 324,563 patients with TAVR, of which 2,613 patients had CRT. The analysis revealed mortality (OR: 2.59, p<0.025, CI: 1.13-5.94), length of stay (LOS) (+5.69 days, p<0.0001, CI: 4.44-6.95), and TOTHC ($165,520, p<0.0001, CI: 134,551-196,489) were increased for patients with TAVR and CRT compared to patients with only TAVR. Secondary analysis is described in Table 1.

Conclusions: Our study revealed that patients with TAVR and CRT had worse outcomes including increased mortality, LOS, and TOTHC. Despite CRT, this patient subpopulation had worse outcomes compared to those with only a TAVR. We suspect that these patients either have a poor functional status at baseline or CRT may not have as much benefit for patients with TAVR. Further studies are required to further evaluate this patient population.

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