1Universitätsklinikum Düsseldorf Klinik für Kardiologie, Pneumologie und Angiologie Düsseldorf, Deutschland
Background
Transcatheter edge-to-edge repair of the mitral valve (M-TEER) is a procedure known for its safety, characterized by low complication rates. In daily practice, post-procedural surveillance on intensive-care or intermediate care unit (ICU, IMCU) at least for 24 hours is often the standard.
The aim of the study was to assess the safety of bypassing IMCU and surveillance in a recovery unit for 4 hours followed by general ward compared to 24 hours intermediate care unit post-procedural care.
Methods
We conducted an analysis of 865 patients who underwent the M-TEER procedure at the University Hospital Düsseldorf between August 2010 and August 2023. Forty patients were prospectively enrolled, who were monitored in the recovery unit for 4 hours after the M-TEER procedure and were subsequently transferred to the general ward.
All patients were divided into two groups: the group of patients who remained in the recovery unit for 4 hours after the procedure (n=40) and those who were monitored in the IMCU (n=825).
Propensity score matching was used to compare the groups (4 hours recovery unit vs 24 hours IMCU) in terms of survival and to reduce confounding factors due to imbalances in baseline characteristics.
Results
Propensity score matching yielded 40 Patients in the recovery unit group and 40 patients in the IMCU group, without a difference in baseline characteristics and aetology of mitral valve insufficiency between the groups.
In the recovery unit group, one patient suffered from Stroke post-procedural diagnosed 19 hours after the procedure, another patient from access-site related bleeding 18 hours after the procedure. Both complications occurred at the general ward. In addition, no further complications were observed during the inpatient stay.
In the IMCU group, one patient experienced bleeding within the first 4 hours, and another patient developed a cardiac arrhythmia requiring interventions after 24 hours, which occured on the general ward.
The 30-day mortality was comparable between both groups. In the Recovery unit group, no patients died, while in the IMCU group, one patient died, which was not procedure-related. (0% vs. 2.5%, p=0.314).
Conclusion
Bypassing ICU/IMCU and surveillance in recovery unit after M-TEER is safe considering the low rates of complications. Further studies are necessary to further highlight the potential benefits of bypassing ICU/IMC regarding less delirium or early mobilization.
I, Haschemi, Jafer: DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.