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Abstract：
OBJECTIVE: Patients affected by functional mitral regurgitation represent an increasingly high-risk population. Edge-to-edge mitral valve repair (TEER) has emerged as a promising treatment option for these patients. However, there is limited research on the comparative outcomes of TEER versus surgical mitral valve repair (SMVr). This study seeks to compare the demographics, complications, and outcomes of TEER and SMVr based on a real-world analysis of the National Inpatient Sample (NIS) database.
RESULTS: In the NIS database, from the years 2016 to 2018, a total of 6233 and 2524 patients who underwent SMVr and TEER were selected, respectively. The mean ages of the patients were 65.68 years (SMVr) and 78.40 years (TEER) (p < 0.01). The mortality rate of patients who received SMVr was similar to that of patients who were treated with TEER (1.7% vs. 1.9%, p = 0.603). Patients who underwent SMVr more likely suffered from perioperative complications including cardiogenic shock (2.3% vs. 0.4%, p < 0.001), cardiac arrest (1.7% vs. 1.1%, p = 0.025), and cerebrovascular infarction (0.9% vs. 0.4%, p = 0.013). The average length of hospital stay was longer (8.59 vs. 4.13 days, p < 0.001) for SMVr compared to TEER; however, the average cost of treatment was higher ($218 728.25 vs. $215 071.74, p = 0.031) for TEER compared to SMVr. Multiple logistic regression analysis showed that SMVr was associated with worse adjusted cardiogenic shock (OR, 7.347 [95% CI, 3.574-15.105]; p < 0.01) and acute kidney injury (OR, 2.793 [95% CI, 2.356-3.311]; p < 0.01).
CONCLUSIONS: Patients who underwent TEER demonstrated a notable decrease in postoperative complications and a shorter hospitalization period when compared to those who underwent SMVr.
RESULTS: In the NIS database, from the years 2016 to 2018, a total of 6233 and 2524 patients who underwent SMVr and TEER were selected, respectively. The mean ages of the patients were 65.68 years (SMVr) and 78.40 years (TEER) (p < 0.01). The mortality rate of patients who received SMVr was similar to that of patients who were treated with TEER (1.7% vs. 1.9%, p = 0.603). Patients who underwent SMVr more likely suffered from perioperative complications including cardiogenic shock (2.3% vs. 0.4%, p < 0.001), cardiac arrest (1.7% vs. 1.1%, p = 0.025), and cerebrovascular infarction (0.9% vs. 0.4%, p = 0.013). The average length of hospital stay was longer (8.59 vs. 4.13 days, p < 0.001) for SMVr compared to TEER; however, the average cost of treatment was higher ($218 728.25 vs. $215 071.74, p = 0.031) for TEER compared to SMVr. Multiple logistic regression analysis showed that SMVr was associated with worse adjusted cardiogenic shock (OR, 7.347 [95% CI, 3.574-15.105]; p < 0.01) and acute kidney injury (OR, 2.793 [95% CI, 2.356-3.311]; p < 0.01).
CONCLUSIONS: Patients who underwent TEER demonstrated a notable decrease in postoperative complications and a shorter hospitalization period when compared to those who underwent SMVr.
摘要：
目的：受功能性二尖瓣反流影响的患者代表了越来越多的高危人群。边缘对边缘二尖瓣修复术（TEER）已成为这些患者的有希望的治疗选择。然而,关于TEER与外科二尖瓣修复术(SMVr)的比较结果的研究有限.这项研究旨在比较人口统计学，并发症,TEER和SMVr的结果基于对国家住院患者样本（NIS）数据库的实际分析。
结果：在NIS数据库中，从2016年到2018年，共选择了6233名和2524名接受SMVr和TEER的患者，分别。患者的平均年龄为65.68岁（SMVr）和78.40岁（TEER）（p<0.01）。接受SMVr的患者的死亡率与接受TEER治疗的患者的死亡率相似（1.7％vs.1.9%，p=0.603）。接受SMVr的患者更有可能发生围手术期并发症，包括心源性休克(2.3%vs.0.4%,p<0.001)，心脏骤停（1.7%vs.1.1%,p=0.025),和脑血管梗塞（0.9%vs.0.4%,p=0.013)。平均住院时间更长（8.59vs.4.13天,与TEER相比，SMVr的p<0.001)；然而，平均治疗费用较高($218728.25vs.与SMVr相比，TEER为215071.74美元，p=0.031）。多因素logistic回归分析显示SMVr与更差的调整心源性休克(OR,7.347[95%CI，3.574-15.105]；p<0.01）和急性肾损伤（OR，2.793[95%CI，2.356-3.311]；p<0.01）。
结论：与接受SMVr的患者相比，接受TEER的患者术后并发症显著减少，住院时间更短。
结果：在NIS数据库中，从2016年到2018年，共选择了6233名和2524名接受SMVr和TEER的患者，分别。患者的平均年龄为65.68岁（SMVr）和78.40岁（TEER）（p<0.01）。接受SMVr的患者的死亡率与接受TEER治疗的患者的死亡率相似（1.7％vs.1.9%，p=0.603）。接受SMVr的患者更有可能发生围手术期并发症，包括心源性休克(2.3%vs.0.4%,p<0.001)，心脏骤停（1.7%vs.1.1%,p=0.025),和脑血管梗塞（0.9%vs.0.4%,p=0.013)。平均住院时间更长（8.59vs.4.13天,与TEER相比，SMVr的p<0.001)；然而，平均治疗费用较高($218728.25vs.与SMVr相比，TEER为215071.74美元，p=0.031）。多因素logistic回归分析显示SMVr与更差的调整心源性休克(OR,7.347[95%CI，3.574-15.105]；p<0.01）和急性肾损伤（OR，2.793[95%CI，2.356-3.311]；p<0.01）。
结论：与接受SMVr的患者相比，接受TEER的患者术后并发症显著减少，住院时间更短。
