Abstract
STUDY OBJECTIVE: Assess the utilization of aortic valve replacements (AVR). DESIGN: Retrospective analysis of the Nationwide Readmissions Database (2016-2018). SETTING: Nationwide. PARTICIPANTS: Heart failure patients with concomitant aortic stenosis (CHF + AS cohort) or aortic stenosis with aortic regurgitation (CHF + AS+AR cohort). INTERVENTIONS: Transcatheter aortic valve implantation (TAVI), surgical aortic valve replacement (SAVR), no-AVR. MAIN OUTCOME MEASURES: Utilization of treatment interventions. RESULTS: In the CHF + AS cohort, TAVI, SAVR and no-AVR were done in 9.3 %, 10.8 % and 79.9 % of patients respectively. Similarly, majority of CHF + AS+AR patients were managed with no-AVR (53.2 %). Of patients managed with no-AVR in the first six months of each year, only 7.9 % of CHF + AS and 11.8 % of CHF + AS+AR patients underwent AVR in the subsequent six months of the year. No-AVR patients had worse short-term outcomes in comparison to AVR recipients. CONCLUSION: More studies are needed to understand the timing, indications and utilization of AVR in this population.