TCT-904 Trends and Outcomes of Mechanical Circulatory Support With Transcatheter Valve Intervention From the National Inpatient Sample (2017-2020)

Document Type

Conference Proceeding

Publication Date

10-29-2024

Publication Title

J Am Coll Cardiol

Abstract

Background: The use of mechanical circulatory support (MCS) devices with transcatheter valve interventions (TVIs) is occasionally required; however, data on their use and outcomes are lacking. Methods: We used the Nationwide Inpatient Sample database to identify patients treated with TVI, with or without MCS, between 2017 and 2020. Our analysis included hospital admissions of adults who underwent transcatheter aortic valve replacement (TAVR), MitraClip, transcatheter mitral valve replacement, transcatheter pulmonary valve replacement (PVR), and/or transcatheter tricuspid valve repair. Results: We identified 29,4525 patients undergoing TVI during the study period, with 2,920 in the MCS group and 292,495 in the non-MCS group (Table). Patients in the MCS group were younger; more likely to be males; of Black or other race; or have congestive heart failure, cardiac arrhythmias, or chronic kidney disease. Younger age, nonelective admission, cardiac arrhythmia, myocardial infarction, sudden cardiac arrest, and cardiogenic shock significantly predicted MCS use (P ≤ 0.001 for all). From 2017 to 2020, there was a steady increase in TVI (P for trend = 0.034). Conversely, use of MCS has remained stable (P for trend: total 0.732). The use of any MCS modality was associated with >30-fold increase in mortality (1% vs 30.1%; P <0.05). Length of stay and cost of hospitalization were higher in the MCS group (P <0.05 for both). Mortality remained steadily high with MCS use (P for trend = 0.138), with declining mortality in the non-MCS group showing a trend toward significance (P for trend = 0.058). [Formula presented] Conclusion: The use of MCS in patients undergoing TVI in the United States between 2017 and 2020 was associated with increased mortality, morbidity, and greater use of health care resources. Further research is needed to enhance the safety and cost-effectiveness of MCS in TVI as well as to identify the optimal MCS for these patients. Categories: STRUCTURAL: Congenital and Other Structural Heart Disease.

Volume

84

Issue

18

First Page

B381

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