National Estimates for the Percentage of all Readmissions With Demographic Features, Morbidity, Overall and Gender-specific Mortality of Transcutaneous vs Open Surgical Tricuspid Valve Replacement/Repair

Abstract

Aims: To determine national estimates for the percentage of all readmissions with demographic features, length of stay, cost analysis, comorbidities, overall and gender-specific mortality, and complications of transcutaneous Tricuspid replacement/repair [TTVR] vs. open surgical tricuspid valve replacement/repair [Open TVR]. Methods: Data was extrapolated from the NRD databases 2015-19. Of the 75,266,750 (unweighted) cases recorded in the 2015 ? 2019 dataset, 429 had one or more of the percutaneous approach codes as per the ICD-10 data set, and 10077 had one or more of the open approach codes. Results: Overall, the number of cases performed each year through open TVR was higher than TTVR, but there was an increased trend towards the TTVR every passing year. TTVR was performed more in females and advanced age groups than open TVR. The length of stay and cost was lower in the TTVR group than in open TVR. Patients undergoing TTVR had more underlying comorbidities like CHF, HTN, and uncomplicated DM. Overall mortality was 3.49 % in TTVR vs. 6.09% in open TVR. Gender-specific analysis demonstrated higher female mortality in the open TVR compared to TTVR (5.45% vs. 3.03 %). Male mortality was statistically insignificant between the two groups (6.8%% vs. 4.3%, p-value 0.15%). Patients with TTVR had lower rates of complications than open TVR, except for arrhythmias, which were higher in TTVR. Patients undergoing open TVR required more intracardiac support, such as IABP and Impella, than TTVR. Conclusion: Transcatheter tricuspid valve replacement/repair is an emerging alternative to open surgical repair/replacement in patients with tricuspid valve diseases, especially tricuspid regurgitation. Despite having more underlying comorbidities, the TTVR group had lower in-hospital mortality, hospital cost, length of stay, and fewer complications than open TVR.