Author + information
- Arka Chatterjee1,
- Nirmanmoh Bhatia2,
- Marc Cribbs3,
- Manyoo Agarwal4,
- Divyanshu Mohananey5,
- Sahil Agrawal6,
- Amrita Mukherjee3 and
- Mark Law3
- 1UAB, Birmingham, Alabama, United States
- 2Vanderbilt University Medical Center, Nashville, Tennessee, United States
- 3University of Alabama at Birmingham, Birmingham, Alabama, United States
- 4University of Tennessee, memphis, Tennessee, United States
- 5Cleveland Cinic, Cleveland, Ohio, United States
- 6St Luke’s University Hospital, Bethlehem, PA, USA, Allentown, Pennsylvania, United States
Volume of Transcatheter pulmonic valve replacement (TPVR) is rising in the United States. We thus aimed to compare theoretical advantages of transcatheter therapy versus surgical pulmonic valve replacement (SPVR) vis-a-vis length of stay and cost using a large national database.
We analyzed the National Inpatient Sample (NIS) database from 2003 to 2014 and compared length of stay and charges for all patients who underwent either TPVR or SPVR. Further analysis was done for elective and non-elective cases separately. Salvage cases were excluded by removing patients with cardiogenic shock from the analysis.
A total of 550 patients underwent TPVR while 10544 patients had SPVR. For all comers, median length of stay for TPVR was 1 day (IQR 1) whereas that for SPVR was 5 days (IQR 3) (p<0.001). This difference persists both for elective (1 v 5 days; p<0.001) and non-elective admissions (2 v 10 days; p < 0.001). Total initial cost is higher for TPVR [Median charges 129,906 (IQR 84,433) v 114,208 (IQR 87,245) dollars; p< 0.001]. This difference persists for elective admissions [Median charges 119,940 (IQR 80,666) v 109,026 (IQR 75,916) dollars; p< 0.001] but not for non-elective admissions [Median charges 144,072 (IQR 98,536) v 152,137 (IQR 145,455) dollars; p=0.98].
Our results from a large US national inpatient database suggest that the length of stay reduction is indeed true for TPVR as compared to SPVR but there may not be a reduction in initial hospital cost.
STRUCTURAL: Congenital and Other Structural Heart Disease