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

## TL;DR

Urgent mitral valve repair is linked to worse hospital outcomes, including higher death rates and more complications, compared to non-urgent procedures.

## Contribution

This study provides a nationwide analysis showing that urgent TEER is associated with significantly worse in-hospital outcomes.

## Key findings

- Urgent TEER was linked to higher in-hospital mortality and complications like cardiogenic shock and major bleeding.
- Patients undergoing urgent TEER had longer hospital stays and higher costs compared to non-urgent cases.
- No significant difference was found in renal replacement therapy or pericardial complications between the groups.

## Abstract

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

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.

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.

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

This study aimed to assess in‐hospital outcomes in patients undergoing urgent versus non‐urgent transcatheter mitral edge‐to‐edge repair, using the National Inpatient Sample database 2016−2019. A total of 29 730 weighted admissions were included. Urgent admissions had a higher risk of in‐hospital mortality, cardiogenic shock, intra‐aortic balloon pump, percutaneous ventricular assist device, mechanical ventilation, acute stroke, in‐hospital cardiac arrest, major bleeding, increased length of stay, and higher total costs compared to non‐urgent admissions.