Transcatheter Aortic Valve Replacement in Patients With Obstructive Sleep Apnea

Close-up of heart valve replacement surgery, operating room, Reykjavik, Iceland
A retrospective study was conducted to examine 3-year complications among patients with obstructive sleep apnea who received transcatheter aortic valve replacement.

The following article is a part of conference coverage from the American College of Cardiology’s 71st Annual Scientific Session & Expo being held in Washington, DC, from April 2 to 4, 2022. The team at Cardiology Advisor will be reporting on the latest news and research conducted by clinicians and scientists in the field. Check back for more from the ACC 2022 .


Patients with obstructive sleep apnea (OSA) who receive transcatheter aortic valve replacement (TAVR) have a higher risk for atrial fibrillation (AF), cardiac arrest, stroke, and redo-TAVR or redo-surgical aortic valve replacement (SAVR) compared with those without OSA. These findings were presented at the American College of Cardiology 71st Annual Scientific Session & Expo, from April 2nd through 4th, in Washington, DC.

A retrospective cohort study was conducted with the use of TriNetX, a national federated real-time database that contains 69 million records. Although short-term outcomes among patients receiving TAVR have been studied, data on long-term outcomes are sparse. The researchers sought to evaluate 3-year complications in patients with OSA who receive TAVR. All patient cohorts were identified if they met OSA criteria and had undergone a TAVR procedure up until October 1, 2018, in order to meet the 3-year follow-up.

A 1:1 matched propensity score analysis was carried out, with adjustments made for patient comorbidities and demographics, in order to calculate adjusted risk ratios (aRRs) with 95% CIs for any complications of interest. Kaplan-Meier analysis was performed to compute survival probability in 3 years among the 2 cohorts.

A total of 2182 participants were enrolled in each study arm. The study arms were patients with OSA and patients without OSA (control arm) who received TAVR. Individuals with OSA had a significantly greater risk for AF (aRR, 1.339; 95% CI, 1.251-1.433), cardiac arrest (aRR, 1.554; 95% CI, 1.144-2.110), stroke (aRR, 1.403; 95% CI, 1.155-1.704), and redo-TAVR or SAVR (aRR, 1.430; 95% CI, 1.134-1.803) compared with those without OSA.

No statistically significant differences were reported between the 2 cohorts in other long-term complications that were evaluated, which included mortality (aRR, 1.045; 95% CI, 0.931-1.172) and pacemaker placement (aRR, 1.170; 95% CI, 0.973 -1.406).

Further, Kaplan-Meier analysis for mortality did not achieve a statistically significant difference in 3-year survival probability in the OSA group vs the control group (hazard ratio, 0.957; 95% CI, 0.841-1.089; P =.5025).

“Additional research is needed to visit further longer-term impacts in patients with [OSA],” the researchers wrote.

Disclosure: None of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies.  


Raiker R. Examining 3-year outcomes in patients with obstructive sleep apnea who underwent transcatheter aortic valve replacement. Presented at: American College of Cardiology 71st Annual Scientific Session & Expo; April 2-4, 2022; Washington, DC.

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