Temporal trends and outcomes of transcatheter mitral valve repair and surgical mitral valve intervention

Ayman Elbadawi, Islam Y. Elgendy, Ahmed H. Mohamed, Mohamed F. Almahmoud, Mohmed Omer, A. Abuzaid, Karim Mahmoud, Gbolahan O. Ogunbayo, Ali Denktas, David Paniagua, Subhash Banerjee, Hani Jneid

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is a paucity of data regarding the contemporary changes in the uptake and outcomes of transcatheter mitral valve repair (TMVR) and surgical mitral valve repair/replacement (SMVR). Methods: We queried the NIS database (2012–2016) to identify hospitalizations for TMVR and SMVR. We reported the temporal trends for uptake of TMVR and SMVR and their in-hospital outcomes. Results: The analysis included 77,645 hospitalizations: 8760 (11.3%) for TMVR and 68,885 (88.7%) for SMVR. Those undergoing TMVR were older and had a higher prevalence of comorbidities, but shorter length of stay (5.5 ± 8.8 vs. 14.3 ± 13.8, p < 0.001) compared with SMVR. There was a marked increase in the number of TMVRs over time (from 420 in 2012 to 3850 in 2016; +917%; Ptrend = 0.008) but a modest increase in the number of SMVRs (+117%; Ptrend = 0.02). Overall, TMVR was associated with low in-hospital mortality (2%) and favorable safety profile. After adjusting for clinical and hospital variables, there were non-significant trends towards lower adjusted mortality among TMVR and SMVR (Ptrend = 0.16 and Ptrend = 0.13, respectively). Notably, among TMVR patients, female sex was associated with lower in-hospital mortality while CKD was associated with increased in-hospital mortality. There was a significant downtrend in the incidences of cardiac arrest, hemodialysis and length of stay in TMVR patients. Conclusion: Real world data showed a steady increase in the number of TMVR and SMVR procedures. Overall, TMVR was associated with low in-hospital mortality and complications rates. Despite older age and increased comorbidities, TMVR patients had lower in-hospital mortality and shorter length than their SMVR counterparts.

Original languageEnglish (US)
JournalCardiovascular Revascularization Medicine
DOIs
StateAccepted/In press - 2020

Keywords

  • Mitraclip
  • Surgical mitral valve intervention
  • Transcatheter mitral valve repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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