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The following is a summary of “National Estimates for the Percentage of All Readmissions With Demographic Features, Morbidity, Overall and Gender-Specific Mortality of Transcutaneous Versus Open Surgical Tricuspid Valve Replacement/Repair,” published in the August 2024 issue of Cardiology by Khan et al.

Transcutaneous tricuspid valve replacement/repair (TTVR) is an emerging alternative to open surgical tricuspid valve replacement/repair (open TVR) in patients with tricuspid valve diseases (TVD), especially tricuspid regurgitation.

Researchers conducted a retrospective study to compare TTVR and open TVR based on demographics, LOS, cost, comorbidities, complications, and mortality rates, both overall and by gender.

They extrapolated data from the Nationwide Readmissions Database (NRD) 2015-19. Of the 75,266,750 (unweighted) cases recorded (2015 – 2019 dataset), 429 had 1 or more of the percutaneous approach codes per the ICD-10 dataset, and 10,077 had 1 or more open approach codes.

The results showed that open TVR had a higher annual case volume than TTVR, and although TTVR’s usage increased each year, TTVR was more common among females and older age groups than open TVR. The LOS and costs were lower with TTVR. Patients undergoing TTVR had more comorbidities, such as congestive heart failure, hypertension, and uncomplicated diabetes mellitus. Overall mortality rates were 3.49% for TTVR and 6.09% for open TVR. Gender-specific analysis revealed higher female mortality with open TVR (5.45%) vs. TTVR (3.03%). Male mortality was similar between the two groups (6.8% vs. 4.3%, P-value = 0.15); TTVR had fewer complications than open TVR, except for higher rates of arrhythmias. Open TVR required more intracardiac support, such as intra-aortic balloon pump (IABP) and Impella, than TTVR.

They concluded that TTVR was a promising alternative to open TVR for TVD, especially tricuspid regurgitation, with lower mortality, cost, LOS, and complications despite a higher comorbidity burden in the TTVR group.

Source: cardiologyres.org/index.php/Cardiologyres/article/view/1625