Key result
Transcatheter mitral valve repair was associated with similar adjusted in-hospital mortality (OR 1.2) and a shorter hospital stay compared to open mitral valve replacement.
Why the study?
TMVR is a minimally invasive alternative to conventional OMVR, but data comparing the burden, demographics, cost, and complications between the two approaches were needed.
Does TMVR compared to OMVR improve in-hospital outcomes in patients requiring mitral valve intervention?
Observational (n=19,580)
Yes
Does TMVR compared to OMVR improve in-hospital outcomes in patients requiring mitral valve intervention?
Odds Ratio: 1.2 (95% CI 0.93–1.68)
Absolute Event Rate: 13.4% vs 5.3%
p-value: p=0.15
TMVR is associated with a shorter hospital stay and similar in-hospital mortality compared to OMVR, though it is more costly and utilized by older, more affluent patients.
BACKGROUND: Transcatheter mitral valve repair and replacement (TMVR) is a minimally invasive alternative to conventional open-heart mitral valve replacement (OMVR). The present study aims to compare the burden, demographics, cost, and complications of TMVR and OMVR. METHODS: -test analysis, respectively. An adjusted odds ratio (aOR) based on the ordinal logistic regression (OLR) model was calculated to determine the association between outcome variables. RESULTS: Of 19,580 patients, 18,460 (94%) underwent OMVR and 1120 (6%) TMVR. Mean ages of patients were 63 ± 14 years (OMVR) and 67 ± 13 years (TMVR). Both cohorts were predominantly Caucasian (73% OMVR vs. 74.0% TMVR). The patients who underwent TMVR were more likely to belong to a household with an income in the highest quartile (26.1% vs. 22.0% for OMVR) versus the lowest quartile (22.1% vs. 27.8%). The average number of days from admission to TMVR was less compared to OMVR (2.63 days vs. 3.02 days, p = 0.015). In-hospital length of stay (LOS) was significantly lower for TMVR compared to OMVR (11.56 vs. 14.01 days, p=<0.0001). Adjusted in-hospital mortality taking into account comorbidities showed no significant difference between the two groups (OR 1.2, 0.93-1.68, p = 0.15). CONCLUSION: Patients undergoing TMVR were older and more financially affluent. TMVR was more costly but was associated with a shorter hospital stay and similar mortality to OMVR.
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Ullah et al. (2020) conducted an observational in Mitral valve regurgitation / Valvular pathology (n=19,580). Transcatheter mitral valve repair (TMVR) vs. Open mitral valve replacement (OMVR) was evaluated on Adjusted in-hospital mortality (OR 1.2, 95% CI 0.93-1.68, p=0.15). Transcatheter mitral valve repair was associated with similar adjusted in-hospital mortality (OR 1.2) and a shorter hospital stay compared to open mitral valve replacement.
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