Abstract 20166: Development of a Risk Prediction Model for 1-Year Mortality After Surgical vs. Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis

Introduction: Treatment options for patients (pts) with severe aortic stenosis (AS) include surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). Although randomized trials have shown similar long-term survival with TAVR and SAVR in selected pts, individual risks may vary. Presently, no tool exists to predict 1 year mortality in AS pts treated with SAVR or TAVR. Methods: Using Medicare claims-linked databases of pts treated with TAVR (Transcatheter Valve Therapy (TVT) registry) or SAVR (Society of Thoracic Surgeons (STS) Registry), we developed a unified risk model to predict 1 year mortality after AVR. Pts aged 65 to 90 yrs, who underwent TAVR (2011-2015) or isolated SAVR or SAVR/CABG (2011-2013) were included in the analysis. Exclusion criteria included inoperability, pure aortic insufficiency, and emergent procedures. Since falsification endpoints indicated substantial unmeasured confounding in non-high risk pts, the model was restricted to pts with STS predicted m...