Does transcatheter valve intervention improve early clinical outcomes and resource utilization compared to surgical valve interventions in adults with valvular heart disease?
Transcatheter valve interventions significantly reduce ICU and hospital length of stay compared to surgical approaches, with comparable early safety profiles despite being performed in older, higher-risk patients.
To evaluate early clinical outcomes and hospital resource utilization across three treatment strategies for valvular heart disease: median sternotomy, right mini-thoracotomy and transcatheter interventions. This retrospective single-center study included 109 consecutive adult patients undergoing valve interventions between January and October 2025 (sternotomy n = 20; mini-thoracotomy n = 25; transcatheter n = 64, including transcatheter aortic valve implantation and mitral/tricuspid edge-to-edge repair). Patients undergoing transcatheter procedures were older and had higher operative risk. Transcatheter interventions were associated with shorter ICU stay (median 1 1–2 vs. 3 2–4 days; p < 0.001) and hospital stay (5 4–7 vs. 7 5–10 and 9 7–12 days; p < 0.001). In-hospital mortality registered one event, with no significant differences between groups (p = 1.00). Rates of stroke, acute kidney injury and permanent pacemaker implantation were low and similar between groups. Reoperation for bleeding occurred only in surgical patients, more frequently after sternotomy (10.0%) than mini-thoracotomy (4.0%) and was absent after transcatheter procedures (0.0%; p = 0.04). Similarly, the composite endpoint of in-hospital events did not differ significantly between groups (20.0% vs. 8.0% vs. 9.4%; p = 0.34).
Marinescu et al. (2026) studied this question.