Urgent Transcatheter Mitral Edge-to-Edge Repair Is Associated With Worse in-Hospital Outcomes: A Nationwide Analysis.

Background: To assess in-hospital outcomes in patients undergoing urgent versus non-urgent transcatheter mitral edge-to-edge repair (TEER).

Methods: We used the NIS database 2016-2019 to include admissions who underwent TEER. Inverse probability of treatment weighting (IPTW) was used to compare urgent versus non-urgent groups.

Results: A total of 29 730 weighted admissions were included, of whom 21.6% were urgent admissions. Urgent admissions had a higher risk of in-hospital mortality (risk ratio [RR] 3.67, 95% confidence interval [CI] 2.39-5.62), cardiogenic shock (RR 4.95, 95% CI 3.73-6.57), intra-aortic balloon pump (RR 3.97, 95% CI 2.53-6.23), percutaneous ventricular assist device (RR 17.24, 95% CI 6.37-46.66), mechanical ventilation (RR 3.79, 95% CI 2.80-5.11), acute stroke (RR 2.56, 95% CI 1.32-4.97), in-hospital cardiac arrest (RR 2.25, 95% CI 1.08-4.69), major bleeding (RR 5.18, 95% CI 2.97-9.06), increased length of stay (6 vs. 2 days, p < 0.001), and higher total costs ($229 160 vs. $164 653, p < 0.01) compared to non-urgent admissions. There was no difference between both groups for renal replacement therapy and pericardial complication.

Conclusion: Our results suggest that urgent TEER implantation was associated with an increased risk of in-hospital death and other short-term complications.