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American Heart Association

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Final ID: Su4062

In-Hospital Outcomes of Open Mitral Valve Repair or Replacement versus Percutaneous Mitral Valve Repair or Replacement in patients with Prior Mediastinal Radiation: Insight from The National Inpatient Database (2015-2020)

Abstract Body (Do not enter title and authors here): Background

Radiation associated heart disease has a wide spectrum of manifestations including pericardial disease, coronary artery disease, and valvular heart disease. Mitral valve regurgitation is the second most common valvular dysfunction in patients with prior mediastinal radiation.

Research Question

What are the outcomes of percutaneous or transcatheter mitral valve replacement/repair (T-MVR) versus surgical mitral valve replacement/repair (S-MVR) in patients with prior mediastinal radiation.

Methods

The National Inpatient Sample (NIS) was analyzed from 2015-2020 to identify patients with mediastinal tumors and prior exposure to radiation therapy undergoing mitral valve repair/replacement. We subclassified the data into hospitalizations for S-MVR and T-MVR. Baseline characteristics were compared between the two groups and multivariate logistic regression was used to analyze hospitalization outcomes.

Results

A total of 1725 patients with prior mediastinal radiation were hospitalized for MVR; 1110 (64.3%) patients underwent S-MVR and 615 (35.6%) patients underwent T-MVR. On a multivariable analysis, the odds of MACCE [aOR: 2.21; 95 % CI: (1.87-4.01); p <0.001)], and in-hospital mortality [aOR: 5.6; 95% CI (2.06-7.35); p=0.008] were higher in patients undergoing S-MVR compared to those undergoing T-MVR. Additionally, patients undergoing S-MVR had higher odds of periprocedural complications including cardiogenic shock [aOR: 7.4; 95% CI: (3.75 -9.20); p <0.001], major bleeding [aOR: 2.9; 95% CI: (1.26-7.09); p=0.01], AKI [aOR: 3.4; 95% CI: (1.33-5.23); p <0.001], stroke [aOR: 5.01; 95% CI: (1.51-6.57); p=0.008], and MCS utilization [aOR: 3.05; 95% CI: (1.31-7.13); p=0.009] compared to the T-MVR cohort.

Conclusion

Compared to T-MVR, S-MVR was associated with higher odds of MACCE, in-hospital mortality and periprocedural complications suggesting that T-MVR might be a safer option for MVR among patients with prior mediastinal radiation.
  • Osama, Muhammad  ( Rochester General Hospital , Rochester , New York , United States )
  • Naeem, Nauman  ( Rochester General Hospital , Rochester , New York , United States )
  • Ahmed, Asmaa  ( Rochester General Hospital , Rochester , New York , United States )
  • Ahmad, Muhammad  ( Advocate Illinois Masonic Medical Center , Chicago , Illinois , United States )
  • Rehman, Saif Ur  ( Rochester General Hospital , Rochester , New York , United States )
  • Sharif, Muhammad Hammad  ( Rochester General Hospital , Rochester , New York , United States )
  • Balmer-swain, Mallory  ( Rochester Regional health , Victor , New York , United States )
  • Author Disclosures:
    Muhammad Osama: DO NOT have relevant financial relationships | Nauman Naeem: No Answer | asmaa ahmed: No Answer | Muhammad Ahmad: DO NOT have relevant financial relationships | Saif ur Rehman: DO NOT have relevant financial relationships | Muhammad Hammad Sharif: DO NOT have relevant financial relationships | Mallory Balmer-Swain: DO NOT have relevant financial relationships
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Open Your Heart To Me: The Role of Invasive Cardiovascular Procedures in the Cancer Patient

Sunday, 11/17/2024 , 11:30AM - 12:30PM

Abstract Poster Session

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