OR2-9 | Management Options For Cardiogenic Shock Due To Stenosed Prosthetic Aortic Valve: A National Cohort Study

Le résumé fourni par la source

A stenosed prosthetic aortic valve (pAV) leading to cardiogenic shock (CS) imposes a clinical challenge with high mortality. We aimed to investigate the best management strategy, including transcatheter aortic valve replacement (TAVR), surgical aortic valve replacement (SAVR), balloon aortic valvuloplasty (BAV), or medical management (MM). We conducted a retrospective cohort study of the National Inpatient Sample database 2016-2020. We included admissions with CS due to stenosed pAV and categorized them into four groups based on the management strategy. Patients who received multiple interventions or had multiple valve pathologies were excluded. A total of 4,325 admissions with CS and stenosed pAV were included (MM: 3,085, TAVR: 430, SAVR: 765, BAV: 45). Inpatient mortality rate was lowest in TAVR group (11.6%, n=50), followed by SAVR (17.6%, n=135), MM (38.2%, n=1,180), and BAV (44.4%, n=20) (p<0.001). After adjusting for variables in Table 1, Only TAVR and SAVR were associated with decreased mortality (compared to MM)(See Table 1). Comparing TAVR to SAVR revealed a lower risk of mortality with TAVR (OR 0.159, 95% CI 0.088-0.287, p<0.001). Patients with CS due to stenosed pAV had high mortality. TAVR appears to provide the best outcome. BAV, reported in a few cases as a bailout for patients who are not candidates for TAVR or SAVR, did not appear to lower the mortality over MM.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.