The relationship of serum lactate level with in-hospital mortality after transcatheter aortic valve implantation.

BACKGROUND

This study assesses the influence of early hyperlactatemia after the transcatheter aortic valve implantation (TAVI) procedure on subsequent outcomes.

METHODS

Adult patients undergoing elective percutaneous TAVI between 2012 and 2022 in a single tertiary cardiac center were retrospectively included. Peak post-procedure lactate level within 24-h was recorded for 284 patients included in the study. The primary outcome measured was 30-day mortality.

RESULTS

19 patients (6.6%) experienced 30-day mortality. Patients with mortality were characterized by advanced age ( = 0.022) and higher lactate levels after the procedure (5.4 ± 5.4 mmol/L vs 1.3 ± 0.6 mmol/L,  < 0.001). Post-procedure hyperlactatemia was an independent predictor of mortality (OR 3.95, 95% CI 1.35-11.60,  = 0.012). ROC analysis revealed 1.54 mmol/L as a cutoff for mortality with 85.7% specificity and 68.4% sensitivity.

CONCLUSION

The initial 24-hour lactate levels seem to play a valuable role in predicting the likelihood of surviving during the hospital stay after the implantation procedure. Further investigation is required to ascertain the optimal strategies for managing early post-procedure hyperlactatemia in the TAVI population.