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Novotny et al. Vessel Plus 2022;6:51 https://dx.doi.org/10.20517/2574-1209.2021.139 Page 13 of 15

echocardiographic information (e.g., aortic valve area, gradient across the valve, velocity across the valve,
and dimensionless index), this clinical information was not available for endpoint risk-adjustment. Based on
billing codes alone, continuous arrhythmias could not be distinguished from intermittent arrhythmias to
analyze for a differential effect on outcomes. Additionally, SPARCS does not include medication details (i.e.,
national drug codes); thus, the impact of different medical management approaches using specific drug
therapies either pre-procedure or perioperatively could not be further investigated.

In conclusion, Pre-operative AF/AFL was not associated with 30-day readmission or the composite
endpoint, consisting of major complications and/or operative mortality, following r-SAVR and viv-TAVR.
However, this study identified other predictors of these adverse outcomes, including black race, Elixhauser
mortality score, and cerebrovascular disease, which may allow clinicians to identify patients at elevated
r-AVR risk.

DECLARATIONS
Acknowledgements
Special thanks are provided to the Biostatistical Consulting Core Lab (Dr. Jie Yang, Director) and to the
Scholarly Concentration Program Research Track (Dr. Howard Fleit, Dr. A. Laurie Shroyer, and Ms.
Rhonda Kearns) at the Renaissance School of Medicine, Stony Brook University for their support of this
medical student research project. Additionally, special thanks are provided to the Office of Quality and
Patient Safety in the New York State Department of Health in Albany, New York for their support for Dr.
Pryor’s SPARCS database records extraction.

Authors’ contributions
Study conception and design: Novotny S, Dokko J, Shroyer AL, Bilfinger T
Data acquisition: Novotny S, Agha S, Yaligar A, Kolba N, Tummala V, Shroyer AL, Bilfinger T
Data analysis: Zhang X, Shroyer AL, Bilfinger T
Administrative, technical, and material support: Parikh PB, Pryor AD, Tannous HJ, Shroyer AL, Bilfinger T
Manuscript writing: Novotny S, Dokko J, Zhang X, Agha S, Yaligar A, Shroyer AL, Bilfinger T
Manuscript editing: Novotny S, Dokko J, Zhang X, Agha S, Yaligar A, Kolba N, Tummala V, Parikh PB,
Pryor AD, Tannous HJ, Shroyer AL, Bilfinger T

Availability of data and materials
Data was obtained from the 2005-2018 New York State Statewide Planning and Research Cooperative
System database.

Financial support and sponsorship
The Stony Brook Renaissance School of Medicine small grant (Dr. Parikh -Principal Investigator; Dr.
Shroyer, co-Principal Investigator) and the Division of Cardiothoracic Surgery General T. F. Cheng
endowment (Dr. Tannous-Principal Investigator) provided partial support for this project.

Conflicts of interest
The authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
This study (IRB2021-00563: Pre-AF r-AVR SPARCS Study) relies on deidentified data reports; thus, this
study was determined to be “not human subjects research” by the institutional review board of the Stony
Brook University Committee on Research in Human Subjects on November 2, 2021.