Abstract 95 Subgroup analysis of self-expanding vs balloon-expandable transcatheter aortic valve replacement in Germany

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Subgroup analysis of self-expanding vs balloon-expandable transcatheter aortic valve replacement in Germany
V. Oettinger¹, I. Hilgendorf¹, D. Wolf¹, P. Stachon¹, K. Kaier², M. Zehender¹, D. Westermann¹, C. von zur Mühlen¹, für die Studiengruppe: CeBAC
¹Klinik für Kardiologie und Angiologie, Universitäts-Herzzentrum, Universitätsklinikum Freiburg, Freiburg im Breisgau; ²Institut für Medizinische Biometrie und Statistik, Universitätsklinikum Freiburg, Freiburg im Breisgau;
Background: Literature showed similar outcomes for self-expanding or balloon-expandable transcatheter aortic valve replacement (TAVR), but subgroup analyzes are lacking. Methods: All self-expanding (SE) or balloon-expandable (BE) transfemoral TAVR for aortic valve stenosis in 2019-2020 in German hospitals were identified. Furthermore, in-hospital outcomes were compared and a subgroup analysis was carried out for in-hospital mortality. Results: 46,243 TAVR were identified (BE: 19,910; SE: 26,333). SE showed a higher logistic EuroSCORE, (SE 13.61%, BE 12.66%; p<0.001) and age (SE 81.55a, BE 79.99a; p<0.001). Also, more patients in SE were female (SE 54.82%, BE 40.06%; p<0.001). In-hospital mortality was comparable between both groups (BE 2.37%, SE 2.35%; p=0.916). After risk adjustment, there was also no significant difference for in-hospital mortality (OR=0.98, p=0.799). Risk of major bleeding was significantly lower in the SE group (OR=0.83, p=0.006). However, SE showed a significantly higher risk of stroke (OR=1.38, p<0.001), delirium (OR=1.15, p=0.001), and permanent pacemaker implantation (OR=1.29, p<0.001). Furthermore, we did not find significant differences for in-hospital mortality with regard to subgroups (age, EuroSCORE, gender, NYHA III/IV, previous CABG, peripheral vascular disease, COPD, pulmonary hypertension, diabetes mellitus). Conclusion: In a subgroup analysis of self-expanding or balloon-expandable TAVR in Germany, we did not find significant differences for in-hospital mortality.
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