Sedhom Ramy, Megaly Michael, Saad Marwan, Elbadawi Ayman, Witzke Christian F, Garcia Santiago, Latib Azeem, Gafoor Sameer A
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA.
Catheter Cardiovasc Interv. 2022 May;99(6):1859-1866. doi: 10.1002/ccd.30141. Epub 2022 Apr 1.
To examine the trends in utilization and outcomes of tricuspid valve (TV) transcatheter edge-to-edge repair (TEER).
Surgery for isolated tricuspid regurgitation is associated with high morbidity and mortality and is rarely performed. TV TEER is an attractive alternative.
The Nationwide Readmissions Database was queried using the International Classification of Diseases, 10th Revision, procedure code for TV TEER for years 2016-2019. The main outcomes were trends in utilization and in-hospital all-cause mortality.
We identified 918 hospitalizations for TV TEER. There was an uptrend in its utilization from 13 cases in the first quarter of 2016 to 122 cases in the last quarter of 2019 (p trend < 0.001). Concomitant mitral valve (MV) TEER was performed in 42.1% of admissions. The overall in-hospital mortality was 2.1%. Surgical TV replacement was needed in 1.1% of admissions; none of them died during the index hospitalization. Unplanned rehospitalizations were common at 30 days (15.7%); 38.2% of those were due to heart failure. There was no difference in in-hospital mortality between isolated TV TEER and combined MV and TV TEER (1.7% vs. 2.6%, p = 0.359). However, admissions receiving combined procedure had lower length of stay and urgent readmission rate.
The current study showed that there was an increase in the utilization of TV TEER over 2016-2019 in the United States. TV TEER was associated with low rates of in-hospital mortality; however, the rate of urgent readmission remains high, mainly due to heart failure.
研究三尖瓣（TV）经导管缘对缘修复术（TEER）的使用趋势和治疗结果。
孤立性三尖瓣反流的手术与高发病率和死亡率相关，且很少进行。TV TEER是一种有吸引力的替代方案。
使用国际疾病分类第十版，查询2016 - 2019年TV TEER的手术代码，以获取全国再入院数据库中的相关信息。主要结果是使用趋势和院内全因死亡率。
我们确定了918例TV TEER住院病例。其使用率呈上升趋势，从2016年第一季度的13例增加到2019年最后一个季度的122例（p趋势<0.001）。42.1%的入院病例同时进行了二尖瓣（MV）TEER。总体院内死亡率为2.1%。1.1%的入院病例需要进行外科TV置换；其中无一例在本次住院期间死亡。计划外再入院在30天时很常见（15.7%）；其中38.2%是由于心力衰竭。孤立性TV TEER与MV和TV联合TEER的院内死亡率无差异（1.7%对2.6%，p = 0.359）。然而，接受联合手术的入院病例住院时间较短，紧急再入院率较低。
当前研究表明，2016 - 2019年美国TV TEER的使用率有所增加。TV TEER与较低的院内死亡率相关；然而，紧急再入院率仍然很高，主要原因是心力衰竭。
