RT Journal Article
SR Electronic
T1 Feasibility and predictors of early discharge after percutaneous edge-to-edge mitral valve repair
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 931
OP 936
DO 10.1136/heartjnl-2016-310501
VO 103
IS 12
A1 Corrado Tamburino
A1 Sergio Buccheri
A1 Antonio Popolo Rubbio
A1 Salvatore Scandura
A1 Maria Elena Di Salvo
A1 Sarah Mangiafico
A1 Sebastiano Immé
A1 Giuseppe Caruso
A1 Matteo Scalia
A1 Antonio Condorelli
A1 Marco Barbanti
A1 Piera Capranzano
A1 Davide Capodanno
A1 Carmelo Grasso
YR 2017
UL http://heart.bmj.com/content/103/12/931.abstract
AB Background Percutaneous edge-to-edge mitral valve repair (PMVR) recently emerged as an effective treatment modality for patients with severe mitral regurgitation (MR). Length of postprocedural hospital stay may represent a modifiable cost associated with percutaneous treatment. We looked at feasibility, predictors and safety of early discharge (ED), defined as hospital discharge within 72 hours, in patients undergoing PMVR.Methods and results Consecutive patients treated with MitraClip from October 2008 to December 2015 were analysed. Primary outcomes of interest were cardiovascular and non-cardiovascular mortality, rehospitalisation for heart failure and major adverse events at 30 days and 90 days. A total of 269 patients were included. Of these, 115 patients were early discharged (ED group). Rates of ED increased from 25.9% for the biennium 2008–2009 to 59.1% in 2014–2015 (p<0.001 for trend). In a penalised logistic regression model, male gender (OR=2.13, 95% CI 1.17 to 3.95) and procedural year (OR=2.13, 95% CI 1.51 to 3.11) were associated with higher probability of ED. Conversely, atrial fibrillation (OR=0.48, 95% CI 0.27 to 0.85), any Mitral Valve Academic Research Consortium bleeding (OR=0.07, 95% CI 0.01 to 0.60), log-transformed N-terminal pro-brain natriuretic peptide levels (OR=0.79, 95% CI 0.63 to 0.99) and postimplant MR grade (OR=0.60, 95% CI 0.37 to 0.94) conferred a lower likelihood of ED. In propensity score-weighted analyses, overall survival, freedom from heart failure and major adverse events at 30 days and 90 days were not different in ED and non-ED groups (all weighted log-rank p value>0.05).Conclusions In selected patients undergoing PMVR, ED may be feasible and safe.