OR13-3
Transcatheter Versus Surgical Mitral Valve Interventions in Patients With Prior Coronary Artery Bypass Grafting
Presenter
Mahmoud Ismayl, M.D., Mayo Clinic, Rochester, MN
Mahmoud Ismayl, M.D.1, Mackram F. Eleid, M.D., FSCAI2, Charanjit S. Rihal, M.D., FSCAI2 and Mayra E. Guerrero, M.D., FSCAI2, (1)Mayo Clinic, Rochester, MN, (2)Mayo Clinic Health System Rochester, Rochester, MN
Keywords: Structural Heart Disease (SHD) and TEER/TMVR/Mitral Valve
Background:
A significant proportion of patients requiring mitral valve (MV) intervention have undergone prior coronary artery bypass grafting (CABG). Data on the outcomes of transcatheter vs. surgical MV interventions in patients with prior CABG are limited.
Methods:
We queried the 2016 to 2020 National Inpatient Sample to identify isolated MV intervention hospitalizations in adults with prior CABG. In-hospital outcomes of transcatheter vs. surgical MV interventions were compared using multivariable regression analysis.
Results:
Of 244,140 MV interventions, 16,010 (6.6%) were in patients with prior CABG. From 2016 through 2020, the number of transcatheter MV interventions in patients with prior CABG increased, whereas the number of surgical MV interventions remained similar. Compared with surgical MV repair and replacement, transcatheter MV repair and replacement were associated with similar odds of in-hospital mortality (adjusted odds ratio [aOR] 0.81, 95% confidence interval 0.66-1.22 for repair; aOR 0.73, 95% CI 0.58-1.31 for replacement) but lower odds of acute kidney injury, permanent pacemaker placement, major bleeding, and need for blood transfusion, respectively (all p<0.01). Stroke and vascular complications were similar between transcatheter versus surgical MV repair and replacement. Length of stay was shorter and total costs were lower with transcatheter MV repair and replacement (all p<0.01).
Conclusions:
In patients with prior CABG, transcatheter MV interventions are associated with similar in-hospital mortality but lower rates of in-hospital complications and resource utilization compared with surgical MV interventions.
