Short-term outcomes of transcatheter aortic valve implantation in patients with concomitant mitral or tricuspid regurgitation.

Mitral regurgitation (MR) or tricuspid regurgitation (TR) is often an indicator of poor prognosis in patients with aortic stenosis (AS). Our study aims to compare transcatheter aortic valve implantation (TAVI) outcomes in patients with and without concomitant MR or isolated TR. Using the national readmission database (2016-2020), we identified patients with severe AS undergoing TAVI. We used multivariable regression for adjusted analysis and the Propensity Score Matching (PSM) model. Among 315,163 hospitalizations for TAVI, 14,577 (4.6 %) had concomitant MR, while 3859 (1.2 %) had isolated TR. On PSM, TAVI in concomitant MR was associated with higher acute CHF (50.1 % vs 43.7 %, p-value < 0.001), mechanical circulatory support (MCS) need (1.5 % vs 0.9 %, p-value: 0.001), acute myocardial infarction (5.6 % vs. 4.3 %, p-value < 0.001) and net adverse events (61.5 % vs. 59.2 %, p-value: 0.002) while the mortality difference was not significant (p > 0.05). Higher total costs ($58,104 vs $55,183, p-value < 0.001), 90- (22.8 % vs. 21.2 %), and 180-day readmission rates (32.1 % vs. 29.4 %) were also observed [p-value < 0.05]. Similarly, TAVI in the presence of isolated TR was associated with higher cardiogenic shock (3.2 % vs. 1.8 %, p: 0.004) and MCS need (1.5 % vs 0.7 %, p: 0.009). TAVI with coexisting TR showed higher rates of 30-day (13.4 % vs. 11.2 %), 90-day (26 % vs. 21.2 %), and 180-day (34.3 % vs 29.1 %) readmission rates [p < 0.05]. A higher median length of stay (3 vs. 2 days) and total cost ($60,376 vs. $55,183) [p-value < 0.001] were also observed. TAVI in concomitant MR or TR was associated with higher periprocedural adverse events, increased healthcare burden & readmission rates.