Author + information
- Fahad Alqahtani,
- Vinay Badhwar,
- Sami Aljohani,
- Ahmed Almustafa,
- Mohammad Akram Kawsara,
- Ali Hama Amin,
- Lawrence Wei,
- J. Scott Rankin and
- Mohamad Alkhouli
Background: Limited data are available on the utilization and outcomes of mitral valve replacement (MVR) in patients with hepatic cirrhosis. We sought to evaluate the national utilization trends and outcomes of MVR in hepatic cirrhosis patients.
Methods: The Nationwide Inpatient Sample was utilized to identify 41,435 patients who underwent isolated MVR between 2004-2013, of whom 287 (0.7%) had hepatic cirrhosis. Multivariable logistic regression derived propensity scores were matched 1:1 to attain 272 matched pairs of isolated MVR with and without cirrhosis to assess in-hospital outcomes and cost.
Results: Over the study period, there was a non-significant increase in MVR utilization in cirrhotic patients accompanied an overall decrease in mortality. Pacemaker implantation and perioperative infections were more frequent in cirrhotic patients (15.8% vs. 9.6%, p=0.029, 2.6% vs. 0.4%, p=0.033, respectively). In-hospital mortality, length of stay, and hospital charges were higher in cirrhotic patients (21.3% vs. 11.4%, p=0.002, 16±17.9 vs. 16±13.5 days, p < 0.001, and 297091±300243$ vs. 252993±258827$, p=0.067, respectively).
Conclusions: In a contemporary nationwide sample, MVR in cirrhotic patients is associated with higher in-hospital mortality, pacemaker implantation, postoperative infection, length of stay and hospital charges compared to non-cirrhotic patients. These findings have important implications in the preoperative risk stratification of patients with cirrhosis.
Moderated Poster Contributions
Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 4:15 p.m.-4:25 p.m.
Session Title: Valvular Heart Disease With CKD or Cirrhosis
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1172M-07
- 2017 American College of Cardiology Foundation