Urgent Transcatheter Mitral Edge-to-Edge Repair Is Associated With Worse in-Hospital Outcomes: A Nationwide Analysis.

BACKGROUND

To assess in-hospital outcomes in patients undergoing urgent versus non-urgent transcatheter mitral edge-to-edge repair (TEER).

METHODS

We used the NIS database 2016-2019 to include admissions who underwent TEER. Inverse probability of treatment weighting (IPTW) was used to compare urgent versus non-urgent groups.

RESULTS

A total of 29 730 weighted admissions were included, of whom 21.6% were urgent admissions. Urgent admissions had a higher risk of in-hospital mortality (risk ratio [RR] 3.67, 95% confidence interval [CI] 2.39-5.62), cardiogenic shock (RR 4.95, 95% CI 3.73-6.57), intra-aortic balloon pump (RR 3.97, 95% CI 2.53-6.23), percutaneous ventricular assist device (RR 17.24, 95% CI 6.37-46.66), mechanical ventilation (RR 3.79, 95% CI 2.80-5.11), acute stroke (RR 2.56, 95% CI 1.32-4.97), in-hospital cardiac arrest (RR 2.25, 95% CI 1.08-4.69), major bleeding (RR 5.18, 95% CI 2.97-9.06), increased length of stay (6 vs. 2 days, p < 0.001), and higher total costs ($229 160 vs. $164 653, p < 0.01) compared to non-urgent admissions. There was no difference between both groups for renal replacement therapy and pericardial complication.

CONCLUSION

Our results suggest that urgent TEER implantation was associated with an increased risk of in-hospital death and other short-term complications.