ViV-TMVR is associated with lower odds of in-hospital mortality, complications, and resource utilization compared to redo surgical mitral valve replacement for failed bioprostheses.
Does transcatheter valve-in-valve implantation reduce in-hospital mortality and complications compared to redo surgical mitral valve replacement in patients with failed mitral bioprostheses?
ViV-TMVR is associated with lower in-hospital mortality and complications compared to redo surgical mitral valve replacement for failed bioprostheses.
Absolute Event Rate: 0% vs 0%
BACKGROUND: Data on the safety of valve-in-valve transcatheter mitral valve replacement (ViV-TMVR) compared with redo surgical mitral valve replacement (SMVR) in patients with a history of bioprosthetic mitral valve (MV) remain limited. AIMS: We aimed to evaluate the in-hospital, 30-day and 6-month readmission outcomes of ViV-TMVR compared with redo-SMVR in a real-world cohort. METHODS: The Nationwide Readmission Database was utilised, analysing data from 2015 to 2019. To determine the adjusted odds ratio (aOR), we used the propensity-matched analysis for major outcomes at index hospitalisation, 30 days, and 6 months during the episode of readmission. RESULTS: A total of 3, 691 patients were included, of these, 24. 2% underwent ViV-TMVR and 75. 8% underwent redo-SMVR. Patients undergoing ViV-TMVR were older with higher rates of comorbidities. The mean length of stay (15 days vs 4 days) and cost of hospitalisation (76, 558 vs 46, 743) were significantly higher for redo-SMVR. The rate of in-hospital all-cause mortality was also significantly lower in ViV-TMVR (2. 6% vs 7. 3%). By contrast, 30-day all-cause mortality during the episode of readmission (aOR 1. 01, 95% confidence interval CI: 0. 40-2. 55) and all-cause readmission rates (aOR 0. 82, 95% CI: 0. 66-1. 02) were similar between both groups. The incidence of all-cause readmissions at 6 months (aOR 0. 83, 95% CI: 0. 65-1. 05) and all-cause mortality during the episode of readmission at 6 months (aOR 1. 84, 95% CI: 0. 54-6. 36) were also comparable. The utilisation of the ViV-TMVR procedure increased significantly during our study duration, from 5. 2% to 36. 8%, (ptrend<0. 01). CONCLUSIONS: ViV-TMVR is associated with lower odds of in-hospital mortality, complications, and resource utilisation. The all-cause readmissions and 30-day and 6-month mortality during the episode of readmissions were comparable between both groups.
Zahid et al. (Tue,) reported a other. ViV-TMVR is associated with lower odds of in-hospital mortality, complications, and resource utilization compared to redo surgical mitral valve replacement for failed bioprostheses.