Temporal trends and outcomes in utilisation of transcatheter and surgical aortic valve therapies in aortic valve stenosis patients with heart failure

INTRODUCTIONS & AIMS: Heart failure (HF) is a common comorbidity in patients undergoing surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). We sought to access the temporal trends and outcomes of TAVR or SAVR in HF patients. METHOD: The NIS database from 2011-2014 was queried for patients that underwent TAVR or SAVR and were subsequently diagnosed with HF. Temporal trends in the utilization of TAVR or SAVR in HF patients were analyzed. RESULTS: Among 27,982 patients who were diagnosed with HF of whom 17,681 (63.2%) had heart failure with reduced ejection fraction (HFrEF) while 10,301 (36.8%) had heart failure with preserved ejection fraction (HFpEF), 9,049 (32.3%) underwent TAVR and 16,933 (76.7%) underwent SAVR. Patients with HFrEF and HFpEF had higher utilization of TAVR compared to SAVR over the course of the study period (p trend < 0.001). TAVR was associated with lower mortality [2.8% in 2012 and 1.8% in 2014 (p 0.013)] compared with SAVR. Similarly, multiple logistic regression showed a statistically significant lower in-hospital mortality in the TAVR group compared to SAVR (aOR 0.634; CI 0.504, 0.798, P < 0.001). CONCLUSION: For patients with severe aortic valve stenosis and heart failure who undergo aortic valve intervention, TAVR is associated with less odds of in-hospital mortality compared with SAVR.