Journal of Clinical Oncology | 2021
In-hospital outcomes of transcatheter aortic valve replacement (TAVR) in patients with localized and metastatic malignancy.
Abstract
e18602 Background: There is limited use of transcatheter aortic valve replacement (TAVR) in patients with malignancy, given that current guidelines do not recommend TAVR in patients with a life expectancy of less than 1 year. Data that compare short-term outcomes after TAVR in cancer and metastasis is scarce. Methods: Using the national inpatient sample (NIS) database, we identified patients who underwent TAVR from 2016-2017 using ICD10-PCS codes. Patients were subsequently divided based on local malignancy and metastatic malignancy. In-hospital mortality, total hospital cost, length of hospital stays, and post-procedural complications were evaluated. Multivariate logistic regression analysis was conducted to adjust for confounders. Results: A total of 91, 624 TAVR hospitalizations were identified, 4, 995 (4.7%) with malignancy. Patients with malignancy were most likely to be women, have a higher Charlson comorbidity index, to use private insurance, and being admitted to a teaching hospital. The most common malignancy was hematological, head and neck, prostate, digestive, and breast cancer of these patients 15.6% had metastatic disease at the time of TAVR. After adjusting for confounders there was no difference in mortality, LOS, healthcare utilization, and post-procedural complications. Conclusions: TAVR seems to have a safe short-term outcome in patients with active malignancy and metastatic disease. In this population, we recommend having an oncological evaluation to perform a risk assessment to aid in the decision when to not proceed with TAVR.[Table: see text]