DOI: 10.1161/circ.148.suppl_1.13786 ISSN: 0009-7322

Abstract 13786: Early Mortality Following Transcatheter Edge-to-Edge Repair of Mitral Regurgitation

Yong Hao Yeo, Min Choon Tan, Qi Xuan Ang, Boon Jian San, Jia Yean Thong, Justin Lee, Kwan S Lee
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Background: While transcatheter edge-to-edge repair (TEER) is increasingly used, data on risk stratification for predicting early mortality after TEER are scarce.

Objective: This study aimed to assess early mortality and analyze the predicting factor of early mortality among patients who underwent TEER.

Methods: Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged 18 years or older who had TEER between January 2017 and November 2020. We categorized the cohort into two groups depending on the occurrence of early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of early mortality after TEER and further analyzed the predictors of early mortality.

Results: 15,931 patients who had TEER were included in this study; 292 (1.8%) with early mortality and 15,639 (98.2%) without. There was a decreasing trend in early mortality from 1.9% in 2017 to 1.7% in 2020, but it was insignificant (p=0.18). In multivariable analysis, the independent predictors for early mortality were chronic kidney disease not requiring dialysis (adjusted odds ratio [aOR]: 1.57; 95% confidence interval [CI]: 1.11-2.22, p=0.01), end-stage renal disease (aOR: 2.34; CI: 1.44-3.79, p<0.01), chronic liver disease (aOR: 4.90; CI: 3.29-7.29, p<0.01), coagulation disorder (aOR: 3.42; CI: 2.32-5.03, p<0.01) and heart failure (aOR: 2.90; CI: 1.39-6.03, p=0.01). Among those who died during 30-day readmission following TEER, the most common cardiac cause and non-cardiac-cause of readmission were heart failure (18.2%) and infection (26.6%), respectively.

Conclusion: The early mortality following TEER was low at 1.8%. The independent predictors of early mortality were chronic kidney disease (including end-stage renal disease), chronic liver disease, coagulation disorder, and heart failure.

Figure Hazard Curves for Early Mortality after TEER Stratified by Clinical Predictors of Early Mortality.

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