Trends and outcomes of mechanical circulatory support with transcatheter aortic valve replacement and transcatheter edge-to-edge repair of the mitral valve from the National Inpatient Sample, 2018 to 2021

Background The use of mechanical circulatory support (MCS) devices with transcatheter aortic valve replacement (TAVR) and mitral transcatheter edge-to-edge repair (mTEER) is occasionally required; however, outcomes data are lacking.Methods We utilized the Nationwide Inpatient Sample database to identify hospital admissions of adults treated with TAVR and mTEER, with or without MCS, between 2018 and 2021.Results We identified 330,055 patients undergoing TAVR and mTEER, with 3240 in the MCS group and 326,815 in the non-MCS group. From 2018 to 2021, there was a steady increase in procedural volume (P for trend <0.001). Utilization of MCS remained stable (P for trend: total 0.096). The use of any MCS modality was associated with a >26-fold increase in mortality (1.01% vs 26.82%, P < 0.001). Mortality remained steadily high with MCS use (P for trend = 0.08). Length of stay and cost of hospitalization were higher in the MCS group (P < 0.05 for both).Conclusion The use of MCS in patients undergoing TAVR or mTEER was associated with higher mortality, morbidity, and healthcare utilization; however, causation cannot be determined given the inherent limitations of the dataset.