Percutaneous Versus Surgical Pulmonic Valve Implantation for Right Ventricular Outflow Tract Dysfunction

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Right ventricular outflow tract (RVOT) dysfunction necessitates valve replacement.
• Percutaneous pulmonic valve implantation (PPVI) has emerged as an alternative to surgical pulmonic valve implantation (SPVI).

Purpose of the Study:

• To compare the clinical outcomes and economic impact of PPVI versus SPVI.
• To evaluate in-hospital mortality, length of stay, complications, and costs associated with both procedures.

Main Methods:

• Retrospective analysis of the 2014 Nationwide Readmissions Database (NRD).
• Utilized International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes to identify patients undergoing PPVI or SPVI.
• Compared outcomes including mortality, length of stay, bleeding, mechanical complications, vascular complications, infective endocarditis, hospitalization charges, and 30-day readmissions.

Main Results:

• PPVI was associated with a significantly shorter length of stay (1 vs. 5 days) and lower risk of bleeding (4.6% vs. 26.4%).
• Total hospitalization charges were significantly lower for PPVI ($169,551.7 vs. $210,681.8).
• No significant differences were observed in all-cause mortality, mechanical complications, vascular complications, infective endocarditis, or 30-day readmission rates between PPVI and SPVI.

Conclusions:

• PPVI demonstrates advantages over SPVI in terms of reduced length of stay, decreased bleeding complications, and lower hospitalization costs.
• Both PPVI and SPVI exhibit comparable safety profiles regarding mortality and major adverse events.