Outcomes of open mitral valve replacement versus Transcatheter mitral valve repair; insight from the National Inpatient Sample Database.

Authors

Waqas Ullah, Abington Jefferson HealthFollow
Yasar Sattar, Icahn School of Medicine at Mount Sinai Elmhurst Hospital
Maryam Mukhtar, Rawalpindi Institute of Cardiology
Hafez M. Abdullah, University of South Dakota
Vincent M. Figueredo, St Mary Medical Center
Donald C. Haas, Abington Jefferson HealthFollow
David L. Fischman, Thomas Jefferson UniversityFollow
M. Chadi Alraies, Detroit Medical Center, DMC Heart Hospital

Document Type

Article

Publication Date

5-28-2020

Comments

This article is the author’s final published version in IJC Heart and Vasculature, Volume 5, June 2020, Article number 100540

The published version is available at https://doi.org/10.1016/j.ijcha.2020.100540. Copyright © Ullah et al.

Abstract

Background: Transcatheter mitral valve repair and replacement (TMVR) is a minimally invasive alternative to conventional open-heart mitral valve replacement (OMVR). The present study aims to compare the burden, demographics, cost, and complications of TMVR and OMVR.

Methods: The United States National Inpatient Sample (US-NIS) for the year 2017 was queried to identify all cases of TMVR and OMVR. Categorical and continuous data were analyzed using Pearson chi-square and independent t-test analysis, respectively. An adjusted odds ratio (aOR) based on the ordinal logistic regression (OLR) model was calculated to determine the association between outcome variables.

Results: Of 19,580 patients, 18,460 (94%) underwent OMVR and 1120 (6%) TMVR. Mean ages of patients were 63 ± 14 years (OMVR) and 67 ± 13 years (TMVR). Both cohorts were predominantly Caucasian (73% OMVR vs. 74.0% TMVR). The patients who underwent TMVR were more likely to belong to a household with an income in the highest quartile (26.1% vs. 22.0% for OMVR) versus the lowest quartile (22.1% vs. 27.8%). The average number of days from admission to TMVR was less compared to OMVR (2.63 days vs. 3.02 days, p = 0.015). In-hospital length of stay (LOS) was significantly lower for TMVR compared to OMVR (11.56 vs. 14.01 days, p=<0.0001). Adjusted in-hospital mortality taking into account comorbidities showed no significant difference between the two groups (OR 1.2, 0.93-1.68, p = 0.15).

Conclusion: Patients undergoing TMVR were older and more financially affluent. TMVR was more costly but was associated with a shorter hospital stay and similar mortality to OMVR.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Recommended Citation

Ullah, Waqas; Sattar, Yasar; Mukhtar, Maryam; Abdullah, Hafez M.; Figueredo, Vincent M.; Haas, Donald C.; Fischman, David L.; and Chadi Alraies, M., "Outcomes of open mitral valve replacement versus Transcatheter mitral valve repair; insight from the National Inpatient Sample Database." (2020). Abington Jefferson Health Papers. Paper 23.
https://jdc.jefferson.edu/abingtonfp/23

PubMed ID

32490147

Language

English