In-hospital outcomes of transcatheter versus surgical aortic valve replacement for nonagenarians

Islam Y. Elgendy, Ahmed N. Mahmoud, Ayman Elbadawi, Akram Y. Elgendy, Mohamed A. Omer, Michael Megaly, Mohammad K. Mojadidi, Hani Jneid

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objectives: To compare the in-hospital outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in nonagenarians. Background: Data comparing the outcomes of TAVR versus SAVR in nonagenarians are limited. Methods: Using the National Inpatient Sample years 2012–2014, hospitalization data were retrieved for subjects aged ≥90 years who underwent TAVR or SAVR for severe aortic stenosis. The incidence of in-hospital mortality and peri-procedural outcomes were compared using unadjusted, multivariate logistic regression, and propensity score matched analyses. Results: The final cohort included 6,680 records of nonagenarians undergoing aortic valve replacement, among which 5,840 (87.4%) underwent TAVR. There was no difference in the incidence of in-hospital mortality between both groups in the unadjusted (5.8% versus 6.0% P = 0.95), multivariate (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.35–1.74), and propensity score matched (OR 1.07, 95% CI 0.75–1.51) analyses. In the propensity-matched analysis, TAVR was associated with a lower incidence of acute kidney injury (OR 0.58, 95% CI 0.47–0.72), post-operative blood transfusion (OR 0.51, 95% CI 0.43–0.61), a higher likelihood of discharge to home (OR 4.71, 95% 3.44–5.06), and a similar incidence of pacemaker placement (OR 1.16, 95% 0.89–1.53) and stroke (OR 1.34, 0.90–1.99). Conclusions: In this nationwide analysis, TAVR was associated with an overall similar incidence of in-hospital mortality and less morbidity compared with SAVR. These findings suggest that TAVR is effective and safe in nonagenarians.

Original languageEnglish (US)
Pages (from-to)989-995
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Issue number5
StatePublished - Apr 1 2019
Externally publishedYes


  • mortality
  • nonagenarian
  • surgical aortic valve replacement
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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