Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer

• Published in: Journal of the American Heart Association 2020-01, Vol.9 (2), p.e014248-e014248
• Main Authors: Guha, Avirup, Dey, Amit K, Arora, Sameer, Cavender, Matthew A, Vavalle, John P, Sabik, III, Joseph F, Jimenez, Ernesto, Jneid, Hani, Addison, Daniel
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; aortic valve replacement; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - surgery; Cardio‐Oncology Spotlight; Databases, Factual; epidemiology; Female; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - mortality; Heart Valve Prosthesis Implantation - trends; Hospital Mortality; Humans; Inpatients; Male; Middle Aged; Neoplasms - diagnosis; Neoplasms - epidemiology; Neoplasms - mortality; oncology; Original Research; Outcome and Process Assessment, Health Care - trends; Postoperative Complications - mortality; Risk Assessment; Risk Factors; Time Factors; transcatheter aortic valve; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - mortality; Transcatheter Aortic Valve Replacement - trends; Treatment Outcome; United States - epidemiology
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.119.014248

Background Patients with cancer and severe aortic stenosis are often ineligible for surgical aortic valve replacement (SAVR). Patients with cancer may likely benefit from emerging transcatheter aortic valve replacement (TAVR), given its minimally invasive nature. Methods and Results The US-based National Inpatient Sample was queried between 2012 and 2015 using ( ), codes to identify all hospitalized adults (aged ≥50 years), who had a primary diagnosis of aortic stenosis. We examined the effect modification of cancer on the relative use rate, outcomes, and dispositions associated with propensity-matched cohort TAVR versus SAVR. Overall, 47 295 TAVRs (22.6% comorbid cancer) and 113 405 SAVRs (15.2% comorbid cancer) were performed among admissions with aortic stenosis between 2012 and 2015. In the year 2015, patients with cancer saw relatively higher rates of TAVR use compared with SAVR (relative use rate versus relative use rate , 67.8% versus 57.2%;