Abstract 11579: In-Hospital Characteristics and Outcomes Among Patients Who Received an Off-Label Tricuspid Clip

Abstract

Intro: Tricuspid regurgitation has high morbidity & mortality, leading to recurrent hospitalization preventing surgery. Tricuspid valve transcatheter edge-to-edge repair with an off-label clip (TVc) are becoming more common, but data are limited. We examined the National Inpatient Sample (NIS) database to describe demographics & in-hospital outcomes among TVc patients. Methods: The NIS database was queried from 2016-2018 to identify patients that received TVc using ICD-10 codes. Weights were applied to obtain national estimates. Results: All P values were <.05. A total of 485 patients received TVc, 94% at large academic medical centers as elective procedures (73%). Patients were older (78±9 Vs 58±20 yrs) with an equal proportion of males & females (45% vs 55%). They were more likely to have comorbidities, like congestive heart failure (88.6% vs 15%), chronic kidney disease (45.3% Vs 16%), hypertension (72.1% vs 52%), atrial fibrillation (85.5% vs 13%) & pulmonary hypertension (47.4% vs 3%). Concomitant mitral regurgitation was the most common valve disorder (7.2% vs. 0.1%). The most common complication was acute kidney injury (32.9% vs 13%), followed by pericardiocentesis (4% vs 0.06%) & cardiac arrest (1% vs 0.01%). Hospital costs rose by six-fold ($303,222 vs $53.5270) & length of stay (LOS) was longer by 3.5 days in those with a TVc. Half of patients were discharged home (54.6%) but 23% required home health & 19% a skilled nursing facility. Conclusions: TVc patients are more likely to be white, older, with an even division in gender & a significant number of chronic comorbidities. Overall mortality is low & complications are rare. Both hospitalization costs & LOS were higher.