Abstract 11607: In-Hospital and Readmission Outcomes With Percutaneous Balloon Mitral Valvuloplasty

Abstract

Introduction: Percutaneous balloon mitral valvuloplasty (PBMV) is primarily performed for rheumatic mitral stenosis (MS). Therefore, limited data exist on PBMV in countries with a low incidence of rheumatic disease. We sought to examine in-hospital and readmission outcomes for PBMV in the U.S. Methods: Using the Nationwide Readmission Database, hospitalizations in which patients received PBMV for rheumatic and non-rheumatic MS were identified. In-hospital mortality and 30-day readmission rate were examined, and multivariable logistic regression was performed for risk adjustment. Additionally, McNemar's test was used to examine the change in 90-day hospitalization rate before vs. after PBMV. Results: Between 2016-2019 there were 1109 hospitalizations in which patients received PBMV for rheumatic (n= 955, 86.1%) vs non-rheumatic MS (n=154, 13.9%) (Figure). In-hospital mortality (odds ratio (OR) 0.67, 95% confidence interval (CI): 0.19-2.25; p=0.52) and 30-day all-cause readmission rate (OR 1.05, 95% CI: 0.54-2.04; p=0.88) were similar with rheumatic vs non-rheumatic MS, respectively. There was no change in 90-day all-cause hospitalization rate after PBMV for rheumatic and non-rheumatic MS (25.5% to 21.8%; p=0.14, and 24.0% to 33.7%; p=0.19, respectively), and similarly among key subgroups except for male and patients <65 years old; (27.7% to 18.1%, p=0.05) and (26.4% to 20.8%, p=0.05) respectively (Figure). Notably the 90-day heart failure-hospitalization rate significantly decreased after PBMV (16.9% to 12.0% [relative reduction 28.9%], p=0.01). Conclusions: Patients who received PBMV for rheumatic and non-rheumatic MS had similar in-hospital mortality and 30-day all-cause readmission rates. There was no change in the 90-day all cause hospitalization rate before and after PBMV however the 90-day heart failure-hospitalizations were significantly reduced. Future studies are needed to examine the role of PBMV in patients without rheumatic MS.