TRANSCATHETER PULMONARY VALVE REPLACEMENT OR REPAIR HAS BETTER IN-HOSPITAL OUTCOMES COMPARED TO SURGERY: A NATIONWIDE STUDY

Document Type

Conference Proceeding

Publication Date

4-1-2025

Publication Title

J Am Coll Cardiol

Keywords

hypertensive factor, acute heart failure, acute kidney failure, adult, artificial ventilation, bleeding, blood transfusion, cardiogenic shock, Caucasian, cohort analysis, conference abstract, drug combination, drug therapy, extracorporeal oxygenation, female, heart arrest, human, major clinical study, male, mortality, observational study, pulmonary valve replacement, surgery

Abstract

Background Reports of comparative outcomes of transcatheter pulmonary valve replacement (TPVR) or repair (TPVr) and surgical pulmonary valve replacement (SPVR) or repair (SPVr) are limited. We aimed to examine in-hospital outcomes of TPVR/TPVr and SPVR/SPVr Methods The National Inpatient Sample Database was utilized to identify TPVR/TPVr and SPVR/SPVr between 2018 and 2021. Patients younger than 18 years of age were excluded. The primary outcome was in-hospital mortality. Secondary outcomes included acute heart failure (AHF), cardiac arrest, ECMO, cardiogenic shock, mechanical ventilation (MV), vasopressor use, blood transfusion, bleeding and acute kidney injury (AKI). Multivariate logistic regression analyses were performed. Results There were 2205 (33%) TPVR/TPVr and 4575 (67%) SPVR/SPVr. Median age 35 (25-50) and 2825 (42%) were Female and 4730 (70%) were white. TPVR/TPVr was associated with significantly lower odds of ECMO, adjusted odds ratio [aOR]:0.17; 95% confidence interval [CI]:0.04-0.77; p=0.02), AKI aOR: 0.26; 0.17-0.41; <.0001, bleeding aOR: 0.07; 0.05-0.11; <.0001, blood transfusion aOR:0.09 (0.04-0.18); <.0001, vasopressor use aOR: 0.13; 0.06 -0.26; <.0001, MV aOR: 0.21; 0.09-0.45; <.0001, and cardiogenic shock aOR: 0.11 (0.05-0.23); <.0001 FIGURE Conclusion Transcatheter pulmonary valve replacement or repair is associated with favorable in-hospital outcomes compared to surgery. There was no difference in mortality between TPVR/TPVr and SPVR/SPVr. [Formula presented]

Volume

85

Issue

12

First Page

957

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