Abstract 19770: TAVR Versus Medical Management Among Patients With Severe Aortic Stenosis and Left Ventricular Systolic Dysfunction

Background: The decision for transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) and left ventricular systolic dysfunction (LSVD) can be challenging. We sought to evaluate mortality differences in patients with AS and LVSD undergoing TAVR compared with a medically matched historical cohort. Methods: We studied 206 patients who underwent TAVR and had an echocardiogram that demonstrated LVSD within six months prior to the procedure and a matched medically managed historical cohort (n = 206). All TAVR patients had severe aortic stenosis and high or extreme risk for open surgical AVR as determined by the Duke multidisciplinary team. Patients were matched 1:1 using optimal matching methods by AS resting mean gradient and/or peak velocity, age, gender, LVEF, and EURO score. LVSD was subclassified into mild (LVEF 36-50%) or severe (LVEF ≤35%). We used Cox multivariable modeling to assess the relationship between TAVR and all-cause mortality censored at 3 years. Results: The median...