National Estimates for the Percentage of all Readmissions With Demographic Features, Morbidity, Overall and Gender-specific Mortality of Transcutaneous vs Open Surgical Tricuspid Valve Replacement/Repair

Aims To determine national estimates for the percentage of all readmissions with demographic features, length of stay, cost analysis, comorbidities, overall and gender-specific mortality and complications of transcutaneous Tricuspid replacement/repair [TTVR] vs. open surgical tricuspid valve replacement/repair [Open TVR]. Methods Data was extrapolated from the NRD databases 2015-19. Of the 75,266,750 (unweighted) cases recorded in the 2015 – 2019 dataset, 429 had one or more of the percutaneous approach codes as per the ICD-10 data set, and 10077 had one or more of the open approach codes. Results Overall, the number of cases performed each year through open TVR was higher than TTVR, but there was an increased trend towards the TTVR every passing year. TTVR was performed more in females and advanced age groups than open TVR. The length of stay and cost was lower in the TTVR group than in open TVR. Patients undergoing TTVR had more underlying comorbidities like CHF, HTN, and uncomplicated DM. Overall mortality was 3.49 % in TTVR vs. 6.09% in open TVR. Gender-specific analysis demonstrated higher female mortality in the open TVR compared to TTVR (5.45% vs. 3.03 %). Male mortality was statistically insignificant between the two groups (6.8%% vs. 4.3%, p-value 0.15%). Patients with TTVR had lower rates of complications than open TVR, except for arrhythmias, which were higher in TTVR. Patients undergoing open TVR required more intracardiac support, such as IABP and Impella, than TTVR. Conclusion Transcatheter tricuspid valve replacement/repair is an emerging alternative to open surgical repair/replacement in patients with tricuspid valve diseases, especially tricuspid regurgitation. Despite having more underlying comorbidities, the TTVR group had lower in- hospital mortality, hospital cost, length of stay, and fewer complications than open TVR. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No payment or services were received from a third party for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.) ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: We used the NRD data set for this research project. NRD is a publicly available data sponsored by Agency for Healthcare Research and Quality. The database was developed for the HCUP [healthcare cost and utilization project] and it houses data on 35 million annual weighted discharges from around 28 States. Each patient is assigned a unique identifier code to trace readmissions within specific calendar year. Given the deidentified nature of the database, Institutional Review Board approval and Informed Consent were not required for this study I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable The data that support the findings of this study are available from the corresponding author, [MK], upon reasonable request.