E-85 | Clinical Characteristics and In-Hospital Outcomes of Patients With Primary Mitral Regurgitation Undergoing MitraClip With Concomitant PCI: A National Inpatient Sample Analysis (2018–2022)

Background: Pulmonary hypertension (PH) frequently coexists with advanced mitral regurgitation and may influence outcomes after transcatheter edge-to-edge mitral valve repair (TEER).Real-world data on TEER outcomes in patients with PH and right-sided heart failure are limited.Methods: Using the National Inpatient Sample (2016-2020), adult hospitalizations undergoing TEER were identified and stratified by PH with right-sided heart failure.The primary outcome was in-hospital mortality; secondary outcomes included procedural complications, length of stay, and costs.Survey-weighted multivariable regression adjusted for patient and hospital characteristics.Results: Among 41,600 patients undergoing TEER, 20% had comorbid PH with right-sided heart failure.PH group was older (mean age 76.7 vs 76.0 years, P<0.001) and more frequently female (48.1% vs 44.4%, P=0.005).There was no significant difference in in-hospital mortality between groups (aOR 1.32, P=0.136).However, PH was associated with higher odds of cardiogenic shock (adjusted OR 1.41, P=0.014) and vascular access complications (adjusted OR 1.81, P=0.042).Rates of AKI, mechanical circulatory support use, major bleeding, sepsis, respiratory failure requiring intubation, cardiac tamponade, length of stay, and total hospitalization costs were similar between groups (all P>0.05).Conclusions: PH with right-sided heart failure was common among TEER patients and was not associated with increased in-hospital mortality, though it conferred higher risk of select complications.TEER appears feasible in this high-risk population with careful peri-procedural management.