Mechanical Circulatory Support Devices and Transcatheter Aortic Valve Implantation (from the National Inpatient Sample)

Singh, Vikas; Patel, Samir; Savani, Chirag; Patel, Nileshkumar; Patel, Nilay; Arora, Shilpkumar; Panaich, Sidakpal; Deshmukh, Abhishek; Cleman, Michael; Mangi, Abeel A.; Forrest, John K.; Badheka, Apurva

doi:10.1016/j.amjcard.2015.08.020

Cited by 36 publications

(44 citation statements)

References 17 publications

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“…In another recently published retrospective study, from Nationwide Inpatient Sample, it was found that 10.6% (n = 190) of patients undergoing TAVR (n = 1,794) required the use of MCS during the same hospitalization . CPB (71.6%) was the most frequently used MCS device followed by IABP (18.9%), ECMO (7.4%), and percutaneous ventricular assist devices (2.1%).…”

Section: Discussionmentioning

confidence: 99%

Elective or Emergency Use of Mechanical Circulatory Support Devices During Transcatheter Aortic Valve Replacement

Singh

Damluji

Mendirichaga

et al. 2016

J Interven Cardiology

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Section: Discussionmentioning

confidence: 99%

Elective or Emergency Use of Mechanical Circulatory Support Devices During Transcatheter Aortic Valve Replacement

Singh

Damluji

Mendirichaga

et al. 2016

J Interven Cardiology

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“…It is therefore of the utmost importance to optimize the hemodynamics in these patients to prevent periprocedural complications. Such patients may receive lower‐support MCS devices such as the intra‐aortic balloon pump and Impella; however some cases ultimately require escalation to the VA‐ECMO due to persistent hemodynamic compromise 7, 21. In a study from the National Inpatient Sample, Singh et al noted 7.4% of TAVR procedures performed in 2011‐2012 required VA‐ECMO support that is likely reflective of early experience and learning curve associated with TAVR 21…”

Section: Discussionmentioning

confidence: 99%

Periprocedural Cardiopulmonary Bypass or Venoarterial Extracorporeal Membrane Oxygenation During Transcatheter Aortic Valve Replacement: A Systematic Review

Vallabhajosyula

Patlolla

Sandhyavenu

et al. 2018

JAHA

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BackgroundThere are limited data on the use of venoarterial extracorporeal membrane oxygenation (VA‐ECMO) or cardiopulmonary bypass (CPB) to provide hemodynamic support periprocedurally during transcatheter aortic valve replacement. This study sought to evaluate patients receiving transcatheter aortic valve replacement with concomitant use of CPB/VA‐ECMO.Methods and ResultsWe systematically reviewed the published literature from 2000 to 2018 for studies evaluating adult patients requiring CPB/VA‐ECMO periprocedurally during transcatheter aortic valve replacement. Studies reporting short‐term and long‐term mortality were included. Given the significant methodological and statistical differences between published studies, meta‐analysis of the association of CPB/VA‐ECMO with mortality was not performed. Of the 537 studies identified, 9 studies representing 5191 patients met our inclusion criteria. Median ages were between 75 and 87 years with 33% to 75% male patients. Where reported, the Edwards SAPIEN™ transcatheter heart valve was the most frequently used. A total of 203 (3.9%) patients received periprocedural hemodynamic support with CPB/VA‐ECMO. Common indications for CPB/VA‐ECMO included left ventricular or aortic annular rupture, rapid hemodynamic deterioration, aortic regurgitation, cardiac arrest, and left main coronary artery obstruction. The use of CPB/VA‐ECMO was predominantly an emergent strategy and was used for durations of 1 to 2 hours. Short‐term mortality (in‐hospital and 30‐day) was 29.8%, and 1‐year mortality was 52.4%. Major complications such as bleeding, vascular injury, tamponade, stroke, and renal failure were noted in 10% to 50% of patients.Conclusions CPB/VA‐ECMO was used in 4% in the early experience of patients undergoing transcatheter aortic valve replacement, most commonly for periprocedural complications. There are limited data on preprocedural planned use of VA‐ECMO, and the characteristics of this population remain poorly defined.

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“…Expectedly in this study, subjects who required mechanical circulatory support during TAVI were less likely to be discharged early. In addition, its use has been reported to predict higher mortality, length of stay, and costs …”

Section: Discussionmentioning

confidence: 99%

“…Considering the administrative nature of the NIS database, it is subject to coding limitations as we used ICD‐9‐CM codes to retrieve study subjects and outcomes. However, similar methods have been used extensively in prior studies . Overall rate of in‐hospital outcomes and healthcare resource utilization should be interpreted with caution as we deliberately excluded patients who did not survive to hospital discharge.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter aortic valve implantation in the United States: Predictors of early hospital discharge

Mallikethi-Reddy

Akintoye

Telila

et al. 2017

J Interven Cardiology

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Mechanical Circulatory Support Devices and Transcatheter Aortic Valve Implantation (from the National Inpatient Sample)

Cited by 36 publications

References 17 publications

Elective or Emergency Use of Mechanical Circulatory Support Devices During Transcatheter Aortic Valve Replacement

Elective or Emergency Use of Mechanical Circulatory Support Devices During Transcatheter Aortic Valve Replacement

Periprocedural Cardiopulmonary Bypass or Venoarterial Extracorporeal Membrane Oxygenation During Transcatheter Aortic Valve Replacement: A Systematic Review

Transcatheter aortic valve implantation in the United States: Predictors of early hospital discharge

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