Author + information
- Sami Aljohani1,
- Fahad Alqahtani2,
- Tatiana Busu1,
- Ahmad Almustafa1,
- Akram Kawsara1 and
- Mohamad Alkhouli1
There is a growing interest in transcatheter therapies for tricuspid regurgitation (TTVR), with several dedicated systems in development. Contemporary outcomes of bioprosthetic tricuspid valve replacement (TVR) surgery can be used as a benchmark for TTVR until randomized trials in the field are completed. However, these data are lacking.
We utilized the nationwide inpatient sample to examine recent trends and outcomes of surgical bioprosthetic TVR (isolated and combined) in the US. Patients with active endocarditis were excluded from the analysis.
11,175 patients who had bioprothetic TVR between 2003-2014 were included, representing a national estimate of 55,302 patients. Of these patients, 27.3% had isolated TVR and 72.7% had concomitant cardiac surgery. In-hospital mortality was 7.9% in the combined TVR group and 7.5% in the isolated MVR group with significant improvement in both groups over the study period (Figure-1). Isolated TVR was associated with significant perioperative morbidities, length of stay and cost of care (Table-1).
|Combined n= (8122)||Isolated (n= 3053)||P value|
|Age- mean (SD), y||64 (19)||33 (28)||<0.0001|
|Female - no (%)||4924 (60.6)||1595 (52.2)||<0.0001|
|In-Hospital Death||642 (7.9)||230 (7.5)||0.515|
|Vascular Complications||438 (5.4)||268 (8.8)||<0.0001|
|Permanent Pacemaker Implantation||1370 (16.9)||537 (17.6)||0.366|
|Clinical Stroke||59 (0.7)||17 (0.6)||0.331|
|Discharged SNF/NH/IC||2329 (28.7)||352 (11.5)||<0.0001|
|Length of Stay- mean (SD), d||15 (15)||19 (28)||<0.0001|
|Total Charges- mean (SD), $||238247 (223597)||287621 (370130)||<0.0001|
Outcomes of TVR have significantly improved over the last decade, but perioperative morbidities and morality remained significant. These data are useful as benchmarks for the evolving TTVR therapies.
STRUCTURAL: Valvular Disease: Other