Transcatheter aortic valve replacement (TAVR) patients with atrial fibrillation (AFib), chronic kidney disease or peripheral vascular disease are more likely to have a stroke, according to new findings published in Current Problems in Cardiology.
“Stroke was among the most common complications identified in the PARTNER trial,” wrote lead author Salman Zahid, MD, of Rochester General Hospital in New York, and colleagues. “Despite improvement in technique and operator experience, stroke remains a devastating complication of TAVR seen in approximately 5% of the patients due to periprocedural embolization.”
Hoping to learn more about how to anticipate this complication in advance, Zahid et al. tracked National Inpatient Sample data from more than 215,000 TAVR patients who underwent the procedure from 2011 to 2018.
More than 4,500 of those patients suffered a stroke after TAVR, good for 2.2% of the patient population. The authors noted that this was considerably lower than the stroke rate in some previous studies, a shift that “could represent robust technologic advancement, delivery techniques and operator experience that has occurred over the past few years.”
Adjusted mortality was 10.9% for patients who had a stroke and 3.1% for those who did not. Patients who had a stroke also had a higher median cost of care ($63,367 vs. $48,070) and longer length of stay (8 days vs. 4 days).
The study’s authors focused on factors that were associated with a post-TAVR stroke. According to their multivariate logistic regression, older patients, women and patients with AFib, chronic kidney disease or peripheral vascular disease were all more likely to have a stroke.
The full analysis is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.