In-Hospital Outcomes of Transcatheter Tricuspid Valve Repair: An Analysis From the National Inpatient Sample.

Background: Patients with severe tricuspid regurgitation carry an elevated surgical risk resulting in increasing adoption of less invasive transcatheter therapies such as transcatheter tricuspid valve repair (TTVR); however, data are limited. This study aimed to describe patient characteristics and predictors of poor outcomes among those undergoing TTVR.

Methods: The National Inpatient Sample was queried (2016-2019) to identify all patients undergoing TTVR ( code 02UJ3JZ) alone or in combination with mitral transcatheter edge-to-edge repair (MTEER) (code 02UG3JZ). The primary aim was to define clinical characteristics, time trends, in-hospital outcomes, and predictors of all-cause in-hospital mortality (mortality). The secondary outcomes included predictors of increased hospitalization costs and length of stay (greater than the 75th percentile).

Results: We identified 925 patients who underwent TTVR (460 [49.7%] who underwent TTVR alone and 465 [50.3%] who underwent TTVR in combination with MTEER). There was a 6.5-fold increase in TTVR adoption ( < .001). Patients were older (78 ± 10 years), female (63.2%), and White (72.7%), with frequent comorbidities. Mortality occurred in 2.2%, vascular complications occurred in 10.3%, and major bleeding occurred in 3.3%. The predictors of mortality were acute kidney injury (odds ratio [OR], 5.25; 95% CI, 5.24-5.26; < .001), major bleeding (OR, 2.81; 95% CI, 2.80-2.83; < .001), pericardiocentesis (OR, 2.15; 95% CI, 2.11-2.18; < .001), and chronic liver disease (OR, 1.40; 95% CI, 1.39-1.40; < .001). The predictors of increased length of stay or hospitalization costs included coronary artery disease, atrial arrhythmias, pulmonary hypertension, chronic liver disease, and procedural complications.

Conclusions: TTVR showed increased adoption with elevated but acceptable mortality and complications considering this high-risk population. The results of randomized trials are awaited.