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

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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
Publication statusPublished - Feb 2016
Externally publishedYes

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Keywords

  • renal complications
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Pant, S., Patel, S., Golwala, H., Patel, N., Pandey, A., Badheka, 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.