Author + information
- Fahad Alqahtani,
- Sami Aljohani,
- Ahmed Almustafa,
- Ashwin Bhirud,
- Stanley Schmidt and
- Mohamad Alkhouli
Background: Conduction abnormalities requiring permanent pacemaker implantation (PPMI) are common after valve replacement surgeries. There is a wide discrepancy in the reported incidence of permanent pacemaker implantation following mitral valve replacement (MVR). We sought to assess the national trends and outcomes of PPMI in patients undergoing MVR.
Methods: We used the Nationwide Inpatient Sample to identify 41434 patients who underwent MVR between 2004-2013, of whom 3955 (12%) required PPMI. Multivariable logistic regression derived propensity scores were matched 1:1 to attain 4927 pairs of patients who underwent PPMI versus those who did not to assess in-hospital outcomes and cost.
Results: Among matched pairs, patients requiring PPM had lower in-hospital mortality (3.5% vs. 8.4%, p < 0.001) but longer median length of stay (18±14.5 vs. 14± 12.7 days, p < 0.001), higher hospital costs (262866±191812$ vs. 207218±179981$, p <0.001), and were more likely to be discharged to intermediate care facility (33% vs. 29%, p < 0.001) compared with those who did not require PPMI. Preoperative rhythm conduction disease was the strongest predictor of post operative PPMI (OR=4, P<0.001).
Conclusions: In contemporary U.S practice, the rates of PPMI following MVR are significantly higher than what have been previously reported. Postoperative PPMI is associated with higher cost, longer length of stay and more intermediate case facility utilization. However, in-hospital mortality was lower in these patients.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Outcomes in Valvular Heart Disease
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1273-026
- 2017 American College of Cardiology Foundation