Author + information
- Prashant Patel,
- Shilpkumar Arora,
- Sopan Lahewala,
- Nirali Patel,
- Ambarish Pathak,
- Abhishek Deshmukh,
- Sidakpal Panaich and
- Apurva Badheka
Background: Intracardiac Echocardiogram (ICE) has demonstrated great potential for guiding percutaneous interventions. However there are no large scale studies comparing outcomes in structural interventions with and without ICE usage.
Methods: We reviewed the data from HCUP's Nationwide Inpatient Sample (NIS) database from 2009-2013 for all admissions for percutaneous interventions using ICD 9-CM codes for ICE (37.28), Transcatheter ASD closure, Percutaneous balloon valvuloplasty, Insertion of LAA device and Septal ablation. Hierarchical two level regression model was used to adjust for confounders to compare in-hospital mortality, complications, hospitalization cost and length of stay (LOS).
Results: Out of 7349(weighted 36,433) percutaneous structural procedures, ICE was used in 1369(18.63%). Univariate analysis showed significantly lower LOS (3.2 days vs 6.2days, p<0.001), in-hospital mortality (0.99% vs 3.41%, p<0.001) and rate of complications (13.66% vs 19.56%, p<0.001) in patients for whom ICE was used. After adjusting for confounders; ICE was a significant predictor of lower composite outcome of in-hospital mortality plus complications (OR, CI, p-value) (0.66, 0.60-0.74, <0.001) as well as lower LOS and costs (Figure 1).
Conclusions: In one of the largest study on ICE guided interventions we demonstrate that ICE is a valuable tool and improves outcomes. Further randomized controlled trials are needed to establish ICE as an integral part of these structural interventions.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Structural Heart Interventions: Focus on Mitral Valve, Left Atrial Appendage and HOCM
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1156-172
- 2017 American College of Cardiology Foundation