Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 14, Number 3, June 2023, pages 228-236

In-Hospital and One-Year Outcomes of Transcatheter Aortic Valve Replacement in Patients Requiring Supplemental Home Oxygen Use

Figure 1. Kaplan-Meier survival analysis post-TAVR in home O₂ and non-home O₂ cohorts. TAVR: transcatheter aortic valve replacement.

**Table 1.** Baseline Clinical Characteristics
Variable	Home O₂ (n = 150)	Non-home O₂ (n = 2,313)	P-value
Results are reported as mean ± SD or n (%). BMI: body mass index; BSA: body surface area; CABG: coronary artery bypass grafting; KCCQ-12: Kansas City Cardiomyopathy Questionnaire 12; MI: myocardial infarction; PCI: percutaneous coronary intervention; PROM: predicted risk of mortality; SAVR: surgical aortic valve replacement; SD: standard deviation; STS: Society of Thoracic Surgeons; TIA: transient ischemic attack.
Demographics
Age (years)	78.9 ± 9.2	81.5 ± 8.3	< 0.001
Female	79 (52.7)	1,051 (45.4)	0.085
BSA (m²)	1.95 ± 0.32	1.89 ± 0.27	0.012
BMI (kg/m²)	29.4 ± 16.1	28.9 ± 16.5	0.406
Race (White)	147 (98.0)	2,227 (96.3)	0.144
Cardiovascular risk factors
Hypertension	132 (88.0)	2,083 (90.1)	0.417
Diabetes mellitus	64 (42.7)	772 (33.4)	0.020
Smoker (current or within 1 year)	27 (18.0)	323 (14.0)	0.170
Prior cardiac history
Previous MI	40 (26.7)	541 (23.4)	0.360
Previous PCI	39 (26.0)	645 (27.9)	0.617
Previous CABG	16 (10.7)	431 (18.6)	0.014
Previous SAVR	11 (7.3)	72 (3.1)	0.666
Previous surgical mitral valve repair/replacement	0 (0.0)	21 (0.9)	0.241
Previous carotid artery stenting/endarterectomy	19 (12.7)	269 (11.6)	0.301
Comorbidities
Atrial fibrillation/flutter
Paroxysmal	24 (16.0)	451 (19.5)	0.428
Persistent	26 (17.3)	439 (19.0)	0.428
Previous stroke	10 (6.6)	246 (10.6)	0.123
Previous TIA	7 (4.7)	148 (6.4)	0.397
Chronic obstructive lung disease	134 (89.3)	956 (41.3)	< 0.001
Peripheral arterial disease	43 (28.7)	514 (22.2)	0.067
Carotid artery disease	54 (36.0)	622 (26.9)	0.034
End stage renal disease	3 (2.0)	63 (2.7)	0.595
Porcelain aorta	4 (2.7)	49 (2.1)	0.654
STS PROM
STS risk score (%)	15.5 ± 10.2	9.3 ± 7.0	< 0.001
Quality of life
KCCQ-12 score	32.5 ± 22.2	49.1 ± 25.4	< 0.001

Table 1. Baseline Clinical Characteristics

Variable

Home O₂ (n = 150)

Non-home O₂ (n = 2,313)

P-value

Results are reported as mean ± SD or n (%). BMI: body mass index; BSA: body surface area; CABG: coronary artery bypass grafting; KCCQ-12: Kansas City Cardiomyopathy Questionnaire 12; MI: myocardial infarction; PCI: percutaneous coronary intervention; PROM: predicted risk of mortality; SAVR: surgical aortic valve replacement; SD: standard deviation; STS: Society of Thoracic Surgeons; TIA: transient ischemic attack.

Demographics

Age (years)

78.9 ± 9.2

81.5 ± 8.3

< 0.001

Female

79 (52.7)

1,051 (45.4)

0.085

BSA (m²)

1.95 ± 0.32

1.89 ± 0.27

0.012

BMI (kg/m²)

29.4 ± 16.1

28.9 ± 16.5

0.406

Race (White)

147 (98.0)

2,227 (96.3)

0.144

Cardiovascular risk factors

Hypertension

132 (88.0)

2,083 (90.1)

0.417

Diabetes mellitus

64 (42.7)

772 (33.4)

0.020

Smoker (current or within 1 year)

27 (18.0)

323 (14.0)

0.170

Prior cardiac history

Previous MI

40 (26.7)

541 (23.4)

0.360

Previous PCI

39 (26.0)

645 (27.9)

0.617

Previous CABG

16 (10.7)

431 (18.6)

0.014

Previous SAVR

11 (7.3)

72 (3.1)

0.666

Previous surgical mitral valve repair/replacement

0 (0.0)

21 (0.9)

0.241

Previous carotid artery stenting/endarterectomy

19 (12.7)

269 (11.6)

0.301

Comorbidities

Atrial fibrillation/flutter

Paroxysmal

24 (16.0)

451 (19.5)

0.428

Persistent

26 (17.3)

439 (19.0)

0.428

Previous stroke

10 (6.6)

246 (10.6)

0.123

Previous TIA

7 (4.7)

148 (6.4)

0.397

Chronic obstructive lung disease

134 (89.3)

956 (41.3)

< 0.001

Peripheral arterial disease

43 (28.7)

514 (22.2)

0.067

Carotid artery disease

54 (36.0)

622 (26.9)

0.034

End stage renal disease

3 (2.0)

63 (2.7)

0.595

Porcelain aorta

4 (2.7)

49 (2.1)

0.654

STS PROM

STS risk score (%)

15.5 ± 10.2

9.3 ± 7.0

< 0.001

Quality of life

KCCQ-12 score

32.5 ± 22.2

49.1 ± 25.4

< 0.001

**Table 2.** Pre-TAVR Laboratory Testing
Variable	Home O₂ (n = 150)	Non-home O₂ (n = 2,313)	P-value
Results are reported as mean ± SD or n (%). AV: aortic valve; CTA: computed tomography angiogram; DLCO: diffusion capacity; FEV₁: forced expiratory volume; SD: standard deviation; TAVR: transcatheter aortic valve replacement.
Baseline echocardiographic data
Left ventricular ejection fraction (%)	55.6 ± 14.6	55.7 ± 13.8	0.942
AV mean gradient (mm Hg)	41.5 ± 14.4	41.8 ± 14.2	0.846
AV peak velocity (m/s)	4.1 ± 0.7	4.1 ± 0.7	0.569
AV area (cm²)	0.8 ± 0.2	0.7 ± 0.2	0.080
Aortic regurgitation			0.185
None	31 (20.6)	546 (23.6)
Trace/trivial	27 (18.0)	437 (18.9)
Mild	73 (48.6)	950 (41.1)
Moderate	13 (8.7)	296 (12.8)
Severe	1 (0.7)	53 (2.3)
Baseline cardiac catheterization data
Number of narrowed coronary arteries			0.117
None	32 (21.3)	467 (20.2)
1	20 (13.3)	372 (16.1)
2	17 (11.3)	401 (17.3)
3	64 (42.7)	801 (34.6)
CTA data
AV annulus size (mm)	23.7 ± 3.2	23.3 ± 3.1	0.160
Pulmonary function testing
FEV₁	50.3 ± 21.1	75.0 ± 24.7	< 0.001
DLCO	48.6 ± 19.2	74.6 ± 22.4	< 0.001

Table 2. Pre-TAVR Laboratory Testing

Variable

Home O₂ (n = 150)

Non-home O₂ (n = 2,313)

P-value

Results are reported as mean ± SD or n (%). AV: aortic valve; CTA: computed tomography angiogram; DLCO: diffusion capacity; FEV₁: forced expiratory volume; SD: standard deviation; TAVR: transcatheter aortic valve replacement.

Baseline echocardiographic data

Left ventricular ejection fraction (%)

55.6 ± 14.6

55.7 ± 13.8

0.942

AV mean gradient (mm Hg)

41.5 ± 14.4

41.8 ± 14.2

0.846

AV peak velocity (m/s)

4.1 ± 0.7

0.569

AV area (cm²)

0.8 ± 0.2

0.7 ± 0.2

0.080

Aortic regurgitation

0.185

None

31 (20.6)

546 (23.6)

Trace/trivial

27 (18.0)

437 (18.9)

Mild

73 (48.6)

950 (41.1)

Moderate

13 (8.7)

296 (12.8)

Severe

1 (0.7)

53 (2.3)

Baseline cardiac catheterization data

Number of narrowed coronary arteries

0.117

None

32 (21.3)

467 (20.2)

20 (13.3)

372 (16.1)

17 (11.3)

401 (17.3)

64 (42.7)

801 (34.6)

CTA data

AV annulus size (mm)

23.7 ± 3.2

23.3 ± 3.1

0.160

Pulmonary function testing

FEV₁

50.3 ± 21.1

75.0 ± 24.7

< 0.001

DLCO

48.6 ± 19.2

74.6 ± 22.4

< 0.001

**Table 3.** Procedural Characteristics
Variable	Home O₂ (n = 150)	Non-home O₂ (n = 2,313)	P-value
Results are reported as mean ± SD or n (%). SD: standard deviation.
Use of anesthesia			< 0.001
General anesthesia	83 (55.3)	1,017 (44.0)
Conscious sedation	67 (44.7)	1,298 (56.1)
Valve type			0.119
Sapien	7 (4.7)	107 (4.6)
Sapien XT	8 (5.3)	74 (3.2)
Sapien 3 (Ultra)	84 (56.0)	1,257 (54.3)
CoreValve	9 (6.0)	91 (3.9)
Evolut R	23 (15.3)	281 (12.1)
Evolut PRO	7 (4.7)	196 (8.5)
Evolut PRO Plus	12 (8.0)	307 (13.3)
Access site			0.001
Femoral	116 (77.3)	2,043 (88.3)
Transcarotid	21 (14.0)	115 (5.0)
Subclavian	7 (4.7)	70 (3.0)
Direct aortic	4 (2.7)	34 (1.5)
Transapical	1 (0.7)	36 (1.6)
Other	1 (0.7)	15 (0.6)
Contrast volume (mL)	92.4 ± 49.3	91.7 ± 58.1	0.879
Fluoroscopy time (min)	21.9 ±10.2	21.2 ± 14.2	0.543

Table 3. Procedural Characteristics

Variable

Home O₂ (n = 150)

Non-home O₂ (n = 2,313)

P-value

Results are reported as mean ± SD or n (%). SD: standard deviation.

Use of anesthesia

< 0.001

General anesthesia

83 (55.3)

1,017 (44.0)

Conscious sedation

67 (44.7)

1,298 (56.1)

Valve type

0.119

Sapien

7 (4.7)

107 (4.6)

Sapien XT

8 (5.3)

74 (3.2)

Sapien 3 (Ultra)

84 (56.0)

1,257 (54.3)

CoreValve

9 (6.0)

91 (3.9)

Evolut R

23 (15.3)

281 (12.1)

Evolut PRO

7 (4.7)

196 (8.5)

Evolut PRO Plus

12 (8.0)

307 (13.3)

Access site

0.001

Femoral

116 (77.3)

2,043 (88.3)

Transcarotid

21 (14.0)

115 (5.0)

Subclavian

7 (4.7)

70 (3.0)

Direct aortic

4 (2.7)

34 (1.5)

Transapical

1 (0.7)

36 (1.6)

Other

1 (0.7)

15 (0.6)

Contrast volume (mL)

92.4 ± 49.3

91.7 ± 58.1

0.879

Fluoroscopy time (min)

21.9 ±10.2

21.2 ± 14.2

0.543

**Table 4.** Comparison of In-Hospital Clinical Outcomes Between Home O₂ and Non-Home O₂ Cohorts
Outcome	Home O₂ (n = 150)	Non-home O₂ (n = 2,313)	P-value
Results are reported as mean ± SD or n (%). SD: standard deviation.
Length of stay
Total (days)	7.9 ± 8.1	5.2 ± 6.3	< 0.001
Post-procedure (days)	5.1 ± 5.7	3.3 ± 4.00	< 0.001
Surgical complications
All-cause mortality	8 (5.3)	36 (1.6)	0.001
Conversion to open heart surgery	2 (1.3)	4 (0.9)	0.554
Procedural cardiac arrest	7 (4.7)	23 (1.0)	< 0.001
Transient ischemic attack	0 (0.0)	14 (0.6)	0.330
Ischemic stroke	5 (3.3)	50 (2.2)	0.388
New-onset atrial fibrillation	6 (4.0)	34 (1.5)	0.013
Major vascular complication	4 (2.7)	42 (1.8)	0.411
Minor vascular complication	9 (6.0)	88 (3.8)	0.146
Composite bleeding	9 (6.0)	78 (3.4)	0.091
New requirement for dialysis	1 (0.7)	5 (0.2)	0.295
Permanent pacemaker	20 (13.3)	293 (12.7)	0.678

Table 4. Comparison of In-Hospital Clinical Outcomes Between Home O₂ and Non-Home O₂ Cohorts

Outcome

Home O₂ (n = 150)

Non-home O₂ (n = 2,313)

P-value

Results are reported as mean ± SD or n (%). SD: standard deviation.

Length of stay

Total (days)

7.9 ± 8.1

5.2 ± 6.3

< 0.001

Post-procedure (days)

5.1 ± 5.7

3.3 ± 4.00

< 0.001

Surgical complications

All-cause mortality

8 (5.3)

36 (1.6)

0.001

Conversion to open heart surgery

2 (1.3)

4 (0.9)

0.554

Procedural cardiac arrest

7 (4.7)

23 (1.0)

< 0.001

Transient ischemic attack

0 (0.0)

14 (0.6)

0.330

Ischemic stroke

5 (3.3)

50 (2.2)

0.388

New-onset atrial fibrillation

6 (4.0)

34 (1.5)

0.013

Major vascular complication

4 (2.7)

42 (1.8)

0.411

Minor vascular complication

9 (6.0)

88 (3.8)

0.146

Composite bleeding

9 (6.0)

78 (3.4)

0.091

New requirement for dialysis

1 (0.7)

5 (0.2)

0.295

Permanent pacemaker

20 (13.3)

293 (12.7)

0.678

**Table 5.** Comparison of 1-Year Clinical Outcomes Between Home O₂ and Non-Home O₂ Cohorts
Outcome	Home O₂ (n = 150)	Non-home O₂ (n = 2,313)	P-value
Results are reported as mean ± SD or n (%). KCCQ-12: Kansas City Cardiomyopathy Questionnaire; SD: standard deviation.
All-cause mortality	26 (17.3)	173 (7.5)	< 0.001
Hospital readmission	12 (7.8)	134 (5.8)	0.320
KCCQ-12 score	69.5 ± 23.8	82.1 ± 19.4	< 0.001

Table 5. Comparison of 1-Year Clinical Outcomes Between Home O₂ and Non-Home O₂ Cohorts

Outcome

Home O₂ (n = 150)

Non-home O₂ (n = 2,313)

P-value

Results are reported as mean ± SD or n (%). KCCQ-12: Kansas City Cardiomyopathy Questionnaire; SD: standard deviation.

All-cause mortality

26 (17.3)

173 (7.5)

< 0.001

Hospital readmission

12 (7.8)

134 (5.8)

0.320

KCCQ-12 score

69.5 ± 23.8

82.1 ± 19.4

< 0.001