Transcatheter Aortic Valve Replacement Complication Rates in Teaching Vs Non-Teaching Centers in the United States

Sadip Pant, Samir Patel, Harsh Golwala, Nilesh Patel, Ambarish Pandey, Apurva Badheka, Kanishk Angihotri, Nilay Patel, Abhishek Deshmukh, Michael P. Flaherty

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

OBJECTIVE: The objective of our study is to compare transcatheter aortic valve replacement (TAVR) complication rates among teaching vs non-teaching centers in the United States. METHODS: Using National Inpatient Sample (NIS) data, the largest all-payer database of hospital inpatient stay available in the United States, we identified patients (age ≥18 years) who underwent TAVR from January-December 2012. We constructed multivariable models to determine independent predictors (age, sex, race, Charlson's comorbidity index, hospital size, hospital location, and TAVR approach) of TAVR-associated complications. RESULTS: We identified 7405 TAVR procedures performed in the United States in 2012. In all, 88% of TAVRs were performed in teaching centers. There was no difference in mortality following TAVR between teaching and non-teaching centers. In-hospital complication rate was lower in teaching centers vs non-teaching centers (42% vs 50%, respectively; P<.001). In adjusted analysis, hemorrhage requiring transfusion (13.2% vs 20.8%; P<.001), renal complications requiring dialysis (1.2% vs 2.3%; P<.01), respiratory complications (7.5% vs 11%; P<.001), and complications requiring open-heart surgery (2% vs 4.6%; P<.001) were lower in teaching centers vs non-teaching centers. Vascular access-site, pacemaker insertion, pericardial, and neurological complications were similar between teaching and non-teaching centers. CONCLUSION: Institutional design impacts TAVR complications, albeit with no difference in mortality. In general, complication rates are lower in teaching centers compared with non-teaching centers.

Original languageEnglish (US)
Pages (from-to)67-70
Number of pages4
JournalJournal of Invasive Cardiology
Volume28
Issue number2
StatePublished - Feb 2016
Externally publishedYes

Keywords

  • renal complications
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Pant, S., Patel, S., Golwala, H., Patel, N., Pandey, A., Badheka, A., Angihotri, K., Patel, N., Deshmukh, A., & Flaherty, M. P. (2016). Transcatheter Aortic Valve Replacement Complication Rates in Teaching Vs Non-Teaching Centers in the United States. Journal of Invasive Cardiology, 28(2), 67-70.