{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:15:46Z","timestamp":1772108146517,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. Racial and Ethnic Health Disparities"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Transcatheter aortic valve replacement (TAVR) has overtaken surgical aortic valve replacement and revolutionized the treatment strategy for aortic valve replacement. Little is known on the disparities among minorities, especially American Indians (AI), undergoing this procedure. We explore TAVR outcomes to identify disparities at our institution.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospective chart review was completed on patients who underwent TAVR at a North Dakota community hospital between 2012 and 2021. There were 1133 non-AI and 20 AI patients identified (<jats:italic>n<\/jats:italic>\u2009=\u20091153). AI patients were identified by enrollment in nationally recognized tribes, Indian Health Service (IHS), or who self-identified as AI. Patient demographics, preoperative characteristics, procedural information, and outcomes were collected. United States 2020 census data was used for state-wide population racial percentages. Unpaired two tail <jats:italic>t<\/jats:italic> test assuming unequal variance and chi-squared tests were used to evaluate data and identify disparities between AI and non-AI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>AI presented at an earlier age (71 vs. 79; <jats:italic>p<\/jats:italic>\u2009=\u2009.001) with higher rates of diabetes (60% vs. 35%; <jats:italic>p<\/jats:italic>\u2009=\u2009.018) and history of smoking (100% vs. 60%; <jats:italic>p<\/jats:italic>\u2009\u2264\u2009.001) than Caucasian\/white (C\/W). The Society of Thoracic Surgery (STS) risk scores (3.2% vs. 4.6%; <jats:italic>p<\/jats:italic>\u2009=\u2009.054) and aortic valve mean gradients were lower among AI (42.8\u00a0mmHg vs. 47.5\u00a0mmHg; <jats:italic>p<\/jats:italic>\u2009=\u2009.010). For those deceased, AI had significantly shorter lifespans post-TAVR compared to C\/W (374\u00a0days vs. 755\u00a0days; <jats:italic>p<\/jats:italic>\u2009=\u2009.004). AI from North Dakota had fewer TAVR procedures performed than expected (4 actual vs. 32 expected; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>AI undergoing TAVR presented earlier, with higher rates of diabetes and smoking, lower STS risk scores, and lesser aortic valve gradients than C\/W. The number of TAVR procedures performed on AI from North Dakota was lower than anticipated despite a nearly 10-year period and the disparities experienced by AI who could have otherwise benefited from TAVR.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40615-023-01604-7","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T14:52:55Z","timestamp":1683039175000},"page":"1254-1259","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Underutilization of Transcatheter Aortic Valve Replacement in Northern Plains American Indians with Severe Aortic Stenosis"],"prefix":"10.1007","volume":"11","author":[{"given":"Jon","family":"Roberts","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chase","family":"Gauthier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Teigen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0956-0218","authenticated-orcid":false,"given":"Hunter","family":"Row","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Sandstrom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Haldis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelius","family":"Dyke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"issue":"11","key":"1604_CR1","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1016\/j.jacc.2013.05.015","volume":"62","author":"R Osnabrugge","year":"2013","unstructured":"Osnabrugge R, Mylotte D, Head S, et al. Aortic stenosis in the elderly. J Am Coll Cardiol. 2013;62(11):1002\u201312. https:\/\/doi.org\/10.1016\/j.jacc.2013.05.015.","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"1604_CR2","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1136\/heart.84.2.211","volume":"84","author":"CM Otto","year":"2000","unstructured":"Otto CM. Timing of aortic valve surgery. Heart. 2000;84(2):211\u20138.","journal-title":"Heart"},{"key":"1604_CR3","doi-asserted-by":"publisher","first-page":"613","DOI":"10.2147\/CEOR.S112691","volume":"8","author":"M Moore","year":"2016","unstructured":"Moore M, Chen J, Mallow PJ, et al. The direct health-care burden of valvular heart disease: evidence from US national survey data. 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The Human Investigation Committee (IRB) of Sanford Health Fargo\u00a0approved this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}