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首页> 外文期刊>The American Journal of Cardiology >Comparison of Transcatheter Mitral Valve Repair Versus Surgical Mitral Valve Repair in Patients With Advanced Kidney Disease (from the National Inpatient Sample)
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Comparison of Transcatheter Mitral Valve Repair Versus Surgical Mitral Valve Repair in Patients With Advanced Kidney Disease (from the National Inpatient Sample)

机译：经截面二尖瓣修复与晚期肾病患者外科二尖瓣修复的比较（来自国家住院样本）

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Transcatheter mitral valve repair (TMVR) is an emerging treatment modality that has been reserved for high-risk patients with multiple co-morbidities. We hypothesize that TMVR is a safe and effective procedure for patients with moderate to severe mitral regurgitation who are not surgical candidates. The National Inpatient Sample (2012 to 2014) using the International Classification of Diseases, 9th Revision, Clinical Modification procedure codes 35.97 for TMVR and 35.12 for surgical mitral valve repair (SMVR) were used. Patients with chronic kidney disease stage IV, Stage V, and end-stage renal disease (ESRD) were considered as patients with advanced kidney disease. A total of 2,123 patients were treated with SMVR and 74 patients were treated with TMVR. There were notably fewer patients treated with TMVR compared with patients treated with SMVR. The mean age was higher with the TMVR group (72.4 vs 61.7 years, p = 0.001). After performing multivariate regression analysis, the primary outcome of in-hospital mortality (13.8% vs 1.3%, adjusted p = 0.003) and all secondary outcomes, excluding dialysis requirement, cardiogenic shock, and cardiac arrest, were significantly lower with the TMVR approach. The average length of stay was lower with TMVR compared with SMVR (22.8 vs 12.6 days, adjusted p = 0.001), with reduced in-hospital costs ($98,165 vs $52,646, adjusted p = 0.001). This large, national study suggests TMVR is associated with significantly lower in-patient morbidity and mortality, with significant cost savings in patients with advanced kidney disease compared with SMVR. Hence, TMVR could be a safe and effective alternative for patients with advanced kidney disease who are not surgical candidates. (C) 2017 Elsevier Inc. All rights reserved.
机译：经导管二尖瓣修复（TMVR）是一种新兴的治疗方式，已经为高风险患者保留了多种辅助病理。我们假设TMVR是一种安全有效的患者，适用于不均匀二尖瓣的患者，该患者不是外科候选者。使用国家住院病人（2012年至2014）使用国际疾病分类，第9次修订，临床修饰程序代码35.97用于TMVR和35.12用于外科直接瓣膜修复（SMVR）。患有慢性肾病阶段IV，阶段V和末期肾病（ESRD）的患者被认为是晚期肾病的患者。共有2,123名患者用SMVR治疗，74名患者用TMVR治疗。与用SMVR治疗的患者相比，用TMVR治疗的患者较少。 TMVR组平均年龄较高（72.4 vs 61.7岁，P = <0.001）。在进行多元回归分析后，院内死亡率的主要结果（13.8％vs 1.3％，调整后P = 0.003）和所有二次结果，不包括透析要求，心肌休克和心脏骤停，随着TMVR方法显着降低。与SMVR相比，TMVR的平均逗留程度较低（22.8 Vs 12.6天，调整后的P = <0.001），降低了医院内的成本（98,165美元VS $ 52,646，调整为P = 0.001）。这一大型国家研究表明，TMVR与患者的病症和死亡率显着降低，与SMVR相比，晚期肾病患者的患者具有显着成本。因此，TMVR可能是没有手术候选人的晚期肾病患者的安全有效的替代品。 （c）2017年Elsevier Inc.保留所有权利。

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