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 x
2 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.
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