Impact of Right Heart Failure on Outcomes of Transcatheter Aortic Valve Implantation: Insights from the National Inpatient Sample.

There are limited data on the impact of right heart failure (RHF) on patients undergoing transcatheter aortic valve implantation (TAVI). We investigated the mortality, in-hospital complications, length of stay, and total hospitalization charges for TAVI admissions, with and without RHF. We analyzed the National Inpatient Sample data from 2018 to 2022. The International Classification of Diseases-Tenth Revision (ICD-10) codes were used to define the patient cohorts. Propensity score weighting was used to balance patient demographic, hospital-level, and comorbidity data. From 2018 to 2022, there were 383,860 TAVI admissions, among which 1915 (0.50%) had the presence of RHF. Compared to patients without RHF, mortality was higher in patients with RHF (7.57% vs. 1.11%, < 0.01). Similarly, acute kidney injury (37.10% vs. 8.56%, < 0.01), respiratory failure (12.79% vs. 1.91%, < 0.01), and use of mechanical circulatory support (11.48% vs. 0.83%, < 0.01) was higher in the cohort with RHF. Median length of stay (7 days vs. 2 days, < 0.01) and hospitalization charges ($257,239 vs. $180,501, < 0.01) were higher in patients with RHF. : In conclusion, we report that RHF is associated with increased mortality risk, complications, and resource utilization in patients undergoing TAVI. Right ventricular function should be a part of the evaluation for TAVI, given significantly elevated risks associated with its presence.