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Purpose <p>Given the systemic nature of connective tissue diseases (CTD), open surgical intervention for aortic stenosis is often considered high risk, making transcatheter aortic valve replacement (TAVR) a potentially preferable alternative. However, data on the impact of CTD on TAVR outcomes remain limited. Therefore, we conducted a nationwide analysis using the National Inpatient Sample <b>(NIS)</b> to examine trends and in-hospital outcomes of TAVR in patients with CTD in the United States.</p> Methods <p>A total of 90,298 patients undergoing TAVR between 2016 and 2022 were identified, representing over 451,000 weighted hospitalizations, including 3,821 (4.2%) with CTD. Multivariable regression was used to adjust for demographic, clinical, and hospital-level characteristics. CTD patients were more frequently female and had higher comorbidity indices, although many differences were small in absolute magnitude.</p> Results <p>In-hospital mortality was comparable between CTD and non-CTD groups (1.0% vs. 1.2%, <i>p</i> = 0.345). Rates of permanent pacemaker implantation and major complications, including vascular events, were similar. CTD patients demonstrated modestly shorter length of stay and lower inflation-adjusted hospitalization costs. Lower rates of cardiogenic shock, cardiac arrest, and mechanical ventilation were observed in the CTD cohort. In-hospital mortality declined significantly over time in the overall cohort, with a similar directional trend in CTD patients that did not reach statistical significance, likely due to smaller sample size.</p> Conclusion <p>Overall, TAVR appears to be a safe and feasible therapeutic option in patients with CTD, with outcomes comparable to those without CTD.</p> Graphical abstract <p></p>

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Trend and clinical outcomes of transcatheter aortic valve replacement in connective tissue disease from the national inpatient sample database (2016–2022)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月24日

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  • Farah Yasmin,
  • Asad Ur Rab,
  • Muhammad Sohaib Asghar,
  • Maryam Shaharyar,
  • M. Chadi Alraies

摘要

Purpose

Given the systemic nature of connective tissue diseases (CTD), open surgical intervention for aortic stenosis is often considered high risk, making transcatheter aortic valve replacement (TAVR) a potentially preferable alternative. However, data on the impact of CTD on TAVR outcomes remain limited. Therefore, we conducted a nationwide analysis using the National Inpatient Sample (NIS) to examine trends and in-hospital outcomes of TAVR in patients with CTD in the United States.

Methods

A total of 90,298 patients undergoing TAVR between 2016 and 2022 were identified, representing over 451,000 weighted hospitalizations, including 3,821 (4.2%) with CTD. Multivariable regression was used to adjust for demographic, clinical, and hospital-level characteristics. CTD patients were more frequently female and had higher comorbidity indices, although many differences were small in absolute magnitude.

Results

In-hospital mortality was comparable between CTD and non-CTD groups (1.0% vs. 1.2%, p = 0.345). Rates of permanent pacemaker implantation and major complications, including vascular events, were similar. CTD patients demonstrated modestly shorter length of stay and lower inflation-adjusted hospitalization costs. Lower rates of cardiogenic shock, cardiac arrest, and mechanical ventilation were observed in the CTD cohort. In-hospital mortality declined significantly over time in the overall cohort, with a similar directional trend in CTD patients that did not reach statistical significance, likely due to smaller sample size.

Conclusion

Overall, TAVR appears to be a safe and feasible therapeutic option in patients with CTD, with outcomes comparable to those without CTD.

Graphical abstract