Outcomes After Transcatheter Aortic Valve Replacement: A Propensity Matched Retrospective Cohort Study.

OBJECTIVES: To examine patient acuity and perioperative outcomes in a contemporary cohort of patients undergoing either transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR).

DESIGN: A retrospective propensity-matched cohort study with univariable logistic regression to assess postoperative outcomes.

SETTING: Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program.

PARTICIPANTS: The study comprised 2,043 patients who underwent either TAVR or SAVR that was reported in the American College of Surgeons-National Surgical Quality Improvement Program.

INTERVENTIONS: None.

MEASUREMENT AND MAIN RESULTS: Age greater than 65 years, patients with dyspnea with moderate exertion or dependence in activities of daily living, high American Society of Anesthesiologists physical status classification, and history of chronic obstructive pulmonary disease were associated with TAVR, whereas body mass index greater than 25 was associated with SAVR. After propensity matching, no differences in 30-day mortality, length of stay, or most postoperative outcomes were observed between the 2 cohorts. Patients undergoing TAVR were less likely to require a perioperative blood transfusion and on an individual patient basis had a lower number of complications than patients in the SAVR group.

CONCLUSIONS: Patients undergoing TAVR have similar mortality, length of stay, and risk for postoperative complications as do patients undergoing SAVR, but patients undergoing TAVR are less likely to have blood transfused.