CONCLUSION With the SAPIEN 3 valve, we found a favourable 30-day outcome after TF TAVR that was largely independent of the type of peri-interventional anaesthesia management. CATEGORIES STRUCTURAL: Valvular Disease: Aortic TCT-726 Aortic Valve Replacement in Patients With Prior Mediastinal Radiation: Transcatheter Vs Surgical Approach Julius I. Ejiofor, 1 Anju Nohria, 2 Anthony Norman, 3 Siobhan McGurk, 4 Charles Nyman, 5 Douglas Shook, 6 Piotr Sobieszczyk, 7 Pinak Shah, 8 Prem Shekar, 9 Marc Pelletier, 10 Tsuyoshi Kaneko 11 1 Scripps Clinic, Boston, Massachusetts, United States; 2 Austin Health; 3 asf; 4 Exponent; 5 John H Stroger, Jr. Hospital of Cook County; 6 Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States; 7 University of Massachusetts Medical School; 8 Unknown, Brookline, Massachusetts, United States; 9 Mount Sinai Beth Israel; 10 Mount Sinai Beth Israel, Boston, Massachusetts, United States; 11 Brigham and Women’s Hospital, Boston, Massachusetts, United States BACKGROUND Mediastinal radiation therapy(MRT) is a risk factor for adverse outcomes after surgical aortic valve replacement(SAVR). Transcatheter aortic valve replacement(TAVR) provides an alternative approach. However, data comparing TAVR to SAVR in patients with prior MRT are lacking. METHODS We identified patients with prior MRT who had under- gone isolated AVR between January, 2002(2012 for TAVR) and May, 2016 at our institution. Concomitant CABG was included, yielding 163 patients(SAVR¼133, TAVR¼30). Operative mortality and post-operative complications were compared between 30 pairs of STS risk score matched SAVR and TAVR patients. RESULTS Mean age was 78.18yrs vs. 709yrs for TAVR and SAVR, respectively(p¼0.24). Among TAVR patients, 24/30(80%) were female vs. 20/30(66.7%) in SAVR, p¼0.38. Mean STS risk score was 5.885% for TAVR and 5.913% for SAVR(p¼0.94). 7/30 (23.3%) of TAVR and 5/30(16.7%) of SAVR patients had undergone prior cardiac surgery (p¼0.57), and 48% of SAVR patients had concomitant CABG. TAVR was performed via a transfemoral approach in 24(80%), transaortic in 4(13.3%) and transapical in 2(6.7%). 30-day operative mortality was zero for TAVR and 3/30(10%) for SAVR (p¼0.24). Post-operative stroke rate was 3.3%(1/30) in both groups(p¼1.0). There was a higher inci- dence of new onset atrial fibrillation with SAVR(0% vs. 23.3%, p<0.011). TAVR had a shorter median ICU(21hrs vs. 58hrs, p<0.001) and hospital stay(4d vs. 12d, p<0.001). 1-year survival was 94.3% for TAVR vs 83.3% for SAVR(p¼0.11) Figure. CONCLUSION Transcatheter aortic valve replacement appears to be an excellent alternative approach for valve replacement in patients with prior mediastinal radiation. It may afford lower post-operative morbidity and shorter hospital stay in this high risk population. CATEGORIES STRUCTURAL: Valvular Disease: Aortic TCT-727 The association between preoperative frailty status and early postoperative mortality and morbidity in high risk TAVR patients: Refining the minimal frailty criteria Dr. A. Kate MacPhedran, MPT, PhD, CCS, 1 Dr.,Yunkai Liu, 2 Dr. Mark Izzo, M.D., FACC 3 1 Gannon University, Erie, Pennsylvania, United States; 2 Center of Cardiovascular Research and Development; 3 SV Consultants in Cardiovascular Diseases, Inc., Erie, Pennsylvania BACKGROUND Transcatheter aortic valve replacement (TAVR) has become a more utilized procedure to perform on patients deemed too frail to handle the demands of surgical aortic valve replacement (SAVR). Assessing frailty in TAVR candidates remains challenging to objectively quantify without a standardized approach or measure. TVT registry requires baseline and 30 day postoperative assessment using the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12), however this is a “general health” tool. One potential as a gold standard is using the five domains of frailty based on Fried’s frailty phenotype (Fried scale), of which a minimum of three domains met deem someone as frail. The aim of this research was to 1)statistically measure which outcome tool most accurately depicted frailty in patients with severe aortic stenosis who under- went TAVR and 2) determine which frailty composite of Fried’s three domains best predicts procedural complications in the TAVR population. METHODS Prior to TAVR, all patients underwent a frailty assessment whereby physical activity and exhaustion scales were administered as well as 5-m gait speed, weight loss amount and grip strength were obtained to derive baseline Fried frailty scores (out of 5) as well as the KCCQ-12 (for KCCQ Summary Score). The cohort was dichotomized according to frail/not frail with  3 criteria met as frail for Fried scale and <60 deemed frail for KCCQ-12 Summary Score, then compared to procedural complications and 30-day mortality. Sensitivity, Speci- ficity and Area under Curve (AUC) were calculated for the two outcome tools and regression models calculated for every 3-domain frailty composite models. RESULTS Baseline frailty was assessed in 83 patients who under- went TAVR (mean age 82.3 years, males 52%, STS 9.2%, KCCQ Summary Score 34.11, Fried scale 3.6/5). There were 5 deaths (6%) and 25 procedural complications (36% total sample), based on prospective data from 2013-2015. KCCQ deemed 77/83 frail and Fried Scale deemed 72/83 frail using stated criteria and based on calculated Sensitivity and Specificity, AUC for KCCQ was 0.5324 versus Fried scale with AUC¼0.6604. Next to grip strength, phys- ical activity (measured by the Late-Life Function and Disability Index) was the strongest single-frailty predictor (AUC¼ 0.5704) and when both were combined with gait speed, this yielded the highest sensitivity/specificity for a 3-domain frailty composite (AUC¼0.5962). CONCLUSION Fried scale should be utilized for assessing frailty in TAVR. CATEGORIES STRUCTURAL: Valvular Disease: Aortic TCT-728 Impact Of Diabetes Mellitus On Outcomes Of Transcatheter Aortic Valve Replacement: A Meta-analysis George Mina, 1 Priyanka Gill, 2 Demiana Soliman, 3 Pratap Reddy, 4 Paari Dominic 5 1 LSUHSC-Shreveport, Shreveport, Louisiana, United States; 2 LSUHSC- Shreveport, Shreveport, Louisiana, United States; 3 national helicopter emergency medical service, Denmark; 4 Universitätsklinikum Jena, Germany; 5 Central Denmark Region Emergency Medical Service, Denmark, Shreveport, Louisiana, United States BACKGROUND Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, data on B294 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 18, SUPPL B, 2016