Periprocedural Complications after Transcatheter Aortic Valve Replacement and their Impact on Resource Utilization

Abstract Background To examine the incidence and trends of peri-procedural complications after TAVR and their impact on resource utilization. Methods The incidence of complications by type [acute kidney injury (AKI), permanent pacemaker (PPM), vascular, paravalvular leak, in-hospital mortality, others] was calculated for TAVR patients at a high-volume center between 2012 and 2018. Clinical data were matched with hospital-billing data of patients. Trends in high resource utilization (discharge to a rehabilitation facility or PLOS > 7 days) (HRU) and complication rates were assessed. Multivariable logistic regression models were used to determine predictors of HRU. Results Out of 1,163 patients, 966 (83%) had no complications, others in 95 (8%), PPM in 56 (5%), AKI alone in 32 (3%), vascular in 31 (3%), in-hospital mortality in 28 (2%) and PVL in 10 (1%). A significant decreasing trend in the incidence of complications (29% vs 10%; p trend Conclusions We established that, post-TAVR resource utilization and morbidity is high among frail and patients with higher STS risk scores. However, these rates decrease over time with experience.