Author + information
- Xiaofan Guoa,b,
- Robert Haywarda,b,
- Eric Vittinghoffa,b,
- Sun Yong Leea,b,
- Ian Harrisa,b,
- Mark Pletchera,b and
- Byron Leea,b
Background: There is a growing population of adult congenital heart disease (CHD) patients in the United States. Data are scarce on outcomes of transvenous lead removal (TLR) in adult CHD.
Methods: We used Healthcare Cost and Utilization Project Nationwide Inpatient Sample to identify TLR procedures in adult patients with and without CHD 2005 to 2012. Outcomes included in-hospital mortality and complications. Multivariable logistic regression models and hierarchical models adjusted for clinical and hospital- related confounders were used in analysis.
Results: We found 101,568 adult patients undergoing TLR, 1175 with simple CHD, 536 with complex CHD and 670 with unspecified CHD. Simple atrial septal defect or patent foramen ovale was the most common congenital defects (871 cases in total). A total of 74.8% CHD patients underwent TLR procedure in teaching hospital. Also, CHD patients who had TLR procedure were more likely to be admitted in hospitals with large bed size and high volume than non-CHD patients (Both P<0.001). Compared to patients without CHD, CHD was associated with a higher risk of any complication even after adjusting for device infection (OR 1.56, 95% CI 1.17-2.07, P=0.003). Simple and complex CHD were associated with 1.6 and 2.0fold risk for any TLR-related complication respectively (OR 1.64, 95% CI 1.09-2.47, P=0.018 for simple CHD; OR 2.01, 95% CI 1.24-3.26, P=0.005 for complex CHD). CHD was not associated with increased risk of in-hospital mortality (adjusted odd ratio [aOR] 1.23, 95% confidence interval [CI] 0.67-2.27, P=0.500).
Conclusions: Despite being more likely to be sent to high volume teaching hospitals, adults with simple and complex CHD undergoing TLR are more likely to have complications without comcommitent increased mortality when compared to patients without CHD. This higher risk should be considered when discussing TLR in adults with CHD.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: The Story of the Adult Congenital Heart Disease Patient and EP
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1102-022
- 2017 American College of Cardiology Foundation