{Reference Type}: Journal Article
{Title}: Transcatheter Versus Surgical Mitral Valve Interventions in Patients With Prior Coronary Artery Bypass Grafting.
{Author}: Ismayl M;Ahmed H;Goldsweig AM;Alkhouli M;Eleid MF;Rihal CS;Guerrero M;
{Journal}: Eur Heart J Qual Care Clin Outcomes
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 19
{Factor}: 7.064
{DOI}: 10.1093/ehjqcco/qcae060
{Abstract}: <B>BACKGROUND: </B>A significant proportion of patients requiring mitral valve (MV) intervention have undergone prior coronary artery bypass grafting (CABG). Reoperative heart surgery is associated with increased risk.<BR><B>OBJECTIVE: </B>To evaluate the utilization and outcomes of transcatheter versus surgical MV interventions in patients with prior CABG.<BR><B>METHODS: </B>We queried the Nationwide Readmission Database (2016-2021) to identify adults with prior CABG hospitalized for transcatheter or surgical MV intervention. In-hospital outcomes were compared using multivariable regression and propensity-matching analyses. Readmissions were compared using Cox proportional hazards regression model.<BR><B>RESULTS: </B>Of 305,625 weighted hospitalizations for MV intervention, 23,506 (7.7%) occurred in patients with prior CABG. From 2016-2021, the use of transcatheter MV interventions increased among patients with prior CABG (72 to 191 for repair and 6 to 45 for replacement per 100,000 hospitalizations, both ptrend<0.001). Compared with surgical MV repair and replacement, transcatheter MV repair and replacement were associated with similar in-hospital mortality (adjusted odds ratio [aOR] 0.44, 95% confidence interval [CI] 0.20-1.03 for repair; aOR 0.61, 95% CI 0.38-1.02 for replacement) and 180-day heart failure readmissions (adjusted hazard ratio [aHR] 1.56, 95% CI 0.85-2.87 for repair; aHR 1.15, 95% CI 0.63-2.09 for replacement) and lower stroke, acute kidney injury, permanent pacemaker placement, length of stay, and nonhome discharges, respectively. Vascular complications were higher with transcatheter versus surgical MV replacement.<BR><B>CONCLUSIONS: </B>Transcatheter MV interventions are increasingly used as the preferred modality of MV intervention in patients with prior CABG and are associated with similar in-hospital mortality and 180-day heart failure readmissions compared with surgical MV interventions.