The Impact of Periprocedural Prosthetic Valve Leak After Transcatheter Aortic Valve Implantation

A periprocedural prosthetic valve leak (PVL) after transcatheter aortic valve implantation (TAVI), a minimally invasive treatment modality for patients with severe, symptomatic aortic stenosis, may entail serious morbidity. Cohorts hospitalized for TAVI from a national database (2016–2020) were stratified on the presence of PVL post-TAVI. TAVI patients with and without PVL were selected for propensity score matching. Pearson’s x2 test was used to compare outcomes. Among 319,448 TAVI patients over five years, 2043 had periprocedural PVL identified at index hospitalization, acute heart failure (49.61% vs. 41.15%, p < 0.001), acute kidney injury (20.40% vs. 11.77%, p < 0.001), cardiac tamponade (1.31% vs. 0.52%, p < 0.05), higher inpatient mortality (3.05% vs. 1.05%, p < 0.001), postprocedural bleeding (3.5% vs. 1.48%, p < 0.001), sudden cardiac arrest (15.34% vs. 8.54%, p < 0.001), and vascular complications (4.10% vs. 1.57%, p < 0.001). TAVI with PVL was associated with a significantly longer length of stay (p < 0.05) and total cost of hospitalization (p < 0.05). The 30-day (15.2% vs. 12%, p = 0.02), 90-day (24.4% vs. 19.9%, p < 0.01), and 180-day (34.7% vs. 24.8%, p < 0.01) readmission rates were significantly higher in the TAVI cohort with PVL. PVL in patients post-TAVI is associated with greater mortality and morbidity during index hospitalization, higher readmission rates, and increased burden on healthcare costs and infrastructure.