Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Review

Volume 15, Number 4, August 2024, pages 223-232

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

**Table 1.** ICD-10 Procedure Codes Used for Identifying TTVR and TVR Procedures
ICD-10 code	Description
TTVR: transcutaneous tricuspid valve replacement/repair; TVR: tricuspid valve replacement/repair.
02QJ	Replacement of tricuspid valve
02QJ0	Replacement of tricuspid valve with synthetic substitute, open approach
02QJ0ZG	Replacement of tricuspid valve with synthetic substitute, open approach, guidewire
02QJ0ZZ	Replacement of tricuspid valve with synthetic substitute, open approach, no device
02QJ3Z	Replacement of tricuspid valve with synthetic substitute, percutaneous endoscopic approach
02QJ3ZG	Replacement of tricuspid valve with synthetic substitute, percutaneous endoscopic approach, guidewire
02QJ3ZZ	Replacement of tricuspid valve with synthetic substitute, percutaneous endoscopic approach, no device
022QJ4	Replacement of tricuspid valve with synthetic substitute, percutaneous approach
02QJ4ZG	Replacement of tricuspid valve with synthetic substitute, percutaneous approach, guidewire
02QJ4ZZ	Replacement of tricuspid valve with synthetic substitute, percutaneous approach, no device

Table 1. ICD-10 Procedure Codes Used for Identifying TTVR and TVR Procedures

ICD-10 code

Description

TTVR: transcutaneous tricuspid valve replacement/repair; TVR: tricuspid valve replacement/repair.

02QJ

Replacement of tricuspid valve

02QJ0

Replacement of tricuspid valve with synthetic substitute, open approach

02QJ0ZG

Replacement of tricuspid valve with synthetic substitute, open approach, guidewire

02QJ0ZZ

Replacement of tricuspid valve with synthetic substitute, open approach, no device

02QJ3Z

Replacement of tricuspid valve with synthetic substitute, percutaneous endoscopic approach

02QJ3ZG

Replacement of tricuspid valve with synthetic substitute, percutaneous endoscopic approach, guidewire

02QJ3ZZ

Replacement of tricuspid valve with synthetic substitute, percutaneous endoscopic approach, no device

022QJ4

Replacement of tricuspid valve with synthetic substitute, percutaneous approach

02QJ4ZG

Replacement of tricuspid valve with synthetic substitute, percutaneous approach, guidewire

02QJ4ZZ

Replacement of tricuspid valve with synthetic substitute, percutaneous approach, no device

**Table 2.** Baseline Characteristics of Patients in TTVR vs. Open TVR
Variables	Percutaneous approach	Open approach	P-value
Standard error in parenthesis. CHF: congestive heart failure; COPD: chronic obstructive pulmonary disease; DM: diabetes mellitus; HTN: hypertension; Open TVR: open surgical tricuspid valve replacement/repair; OSA: obstructive sleep apnea; TTVR: transcutaneous tricuspid valve replacement/repair.
Mean age (years)	57.8 (1.2458)	40.8 (1.2752)	< 0.001
Female gender (%)	66.04 (2.4172)	55.20 (0.6283)	< 0.001
Comorbidities (%)
CHF	75.43 (2.3292)	53.48 (1.1088)	< 0.001
DM - uncomplicated	8.74 (1.5020)	5.41 (0.2946)	0.029
DM - complicated	0 (0)	0.83 (0.0266)	0.002
COPD	19.9 (1.9635)	16.6 (0.6808)	0.1089
HTN	61.16 (2.8370)	45.53 (1.1936)	< 0.001
HTN - complicated	11.03 (1.5900)	17.38 (0.5095)	< 0.001
HTN - uncomplicated	50.5 (3.0331)	28.9 (1.0479)	< 0.001
OSA	16.1 (1.9607)	7.96 (0.3721)	< 0.001

Table 2. Baseline Characteristics of Patients in TTVR vs. Open TVR

Variables

Percutaneous approach

Open approach

P-value

Standard error in parenthesis. CHF: congestive heart failure; COPD: chronic obstructive pulmonary disease; DM: diabetes mellitus; HTN: hypertension; Open TVR: open surgical tricuspid valve replacement/repair; OSA: obstructive sleep apnea; TTVR: transcutaneous tricuspid valve replacement/repair.

Mean age (years)

57.8 (1.2458)

40.8 (1.2752)

< 0.001

Female gender (%)

66.04 (2.4172)

55.20 (0.6283)

< 0.001

Comorbidities (%)

CHF

75.43 (2.3292)

53.48 (1.1088)

< 0.001

DM - uncomplicated

8.74 (1.5020)

5.41 (0.2946)

0.029

DM - complicated

0 (0)

0.83 (0.0266)

0.002

COPD

19.9 (1.9635)

16.6 (0.6808)

0.1089

HTN

61.16 (2.8370)

45.53 (1.1936)

< 0.001

HTN - complicated

11.03 (1.5900)

17.38 (0.5095)

< 0.001

HTN - uncomplicated

50.5 (3.0331)

28.9 (1.0479)

< 0.001

OSA

16.1 (1.9607)

7.96 (0.3721)

< 0.001

**Table 3.** National Estimate for Percentage of All Readmissions for TTVR vs. Open TVR
Year	Percutaneous approach	Open approach
Open TVR: open surgical tricuspid valve replacement/repair; TTVR: transcutaneous tricuspid valve replacement/repair.
2015	0.0003197 (10^-3.4)	0.0147 (10^-1.83)
2016	0.0002789 (10^-3.5)	0.0144 (10^-1.84)
2017	0.0004506 (10^-3.3)	0.0148 (10^-1.82)
2018	0.0005399 (10^-3.2)	0.0143 (10^-1.84)
2019	0.0007247 (10^-3.1)	0.0147 (10^-1.83)

Table 3. National Estimate for Percentage of All Readmissions for TTVR vs. Open TVR

Year

Percutaneous approach

Open approach

Open TVR: open surgical tricuspid valve replacement/repair; TTVR: transcutaneous tricuspid valve replacement/repair.

2015

0.0003197 (10^-3.4)

0.0147 (10^-1.83)

2016

0.0002789 (10^-3.5)

0.0144 (10^-1.84)

2017

0.0004506 (10^-3.3)

0.0148 (10^-1.82)

2018

0.0005399 (10^-3.2)

0.0143 (10^-1.84)

2019

0.0007247 (10^-3.1)

0.0147 (10^-1.83)

**Table 4.** In-Hospital Outcomes of TTVR vs. Open TVR
Variables	Percutaneous approach	Open approach	P-value
Standard error in parenthesis. LOS: length of stay; Open TVR: open surgical tricuspid valve replacement/repair; TTVR: transcutaneous tricuspid valve replacement/repair.
Mean LOS (days)	9.85 (0.7845)	23 (0.4566)	< 0.001
Overall mortality (%)	3.49 (0.8874)	6.09 (0.3066)	0.0057
Female mortality	3.03 (1.0185)	5.45 (0.3812)	0.023
Male mortality	4.39 (1.6394)	6.82 (0.4528)	0.1534
Cost (dollars)	308,394	509,107

Table 4. In-Hospital Outcomes of TTVR vs. Open TVR

Variables

Percutaneous approach

Open approach

P-value

Standard error in parenthesis. LOS: length of stay; Open TVR: open surgical tricuspid valve replacement/repair; TTVR: transcutaneous tricuspid valve replacement/repair.

Mean LOS (days)

9.85 (0.7845)

23 (0.4566)

< 0.001

Overall mortality (%)

3.49 (0.8874)

6.09 (0.3066)

0.0057

Female mortality

3.03 (1.0185)

5.45 (0.3812)

0.023

Male mortality

4.39 (1.6394)

6.82 (0.4528)

0.1534

Cost (dollars)

308,394

509,107

**Table 5.** Complications of TTVR vs. Open TVR
Variables	Percutaneous approach	Open approach	P-value
Data are presented as the weighted percentage with standard error in parenthesis. ARDS: acute respiratory distress syndrome; ECMO: extracorporeal membrane oxygenation; IABP: intra-aortic balloon pump; LVAD: left ventricular assist device; Open TVR: open surgical tricuspid valve replacement/repair; TTVR: transcutaneous tricuspid valve replacement/repair.
Major bleed	4.2632 (1.0269)	4.4781 (0.2580)	0.839
Cardiac arrest	1.0505 (0.4580)	2.7872 (0.1913)	< 0.001
ARDS	0 (0)	0.7294 (0.0939)	< 0.001
Cardiac tamponade	0.2127 (0.2113)	1.9164 (0.1504)	< 0.001
Pleural effusion	1.1908 (0.5212)	8.3524 (0.3403)	< 0.001
Arrhythmias	76.2786 (2.3614)	62.2894 (1.1188)	< 0.001
IABP	1.6158 (0.7511)	4.7343 (0.3247)	< 0.001
Impella	0.1907 (0.1912)	0.5093 (0.0723)	0.119
ECMO	0.7012 (0.4101)	0.7506 (0.1093)	0.907
Permanent pacemaker	4.1286 (0.9556)	12.7029 (0.5321)	< 0.001
Stroke	0.5738 (0.4165)	1.4839 (0.1282)	0.037
LVAD	0.4611 (0.3281)	1.8043 (0.2020)	< 0.001
Blood loss anemia	1.0130 (0.4428)	1.2706 (0.1410)	0.568
Infective endocarditis	3.57 (1.0050)	25	< 0.001
Paravalvular leak	2.36 (0.8487)	0.56 (0.0798)	0.035

Table 5. Complications of TTVR vs. Open TVR

Variables

Percutaneous approach

Open approach

P-value

Data are presented as the weighted percentage with standard error in parenthesis. ARDS: acute respiratory distress syndrome; ECMO: extracorporeal membrane oxygenation; IABP: intra-aortic balloon pump; LVAD: left ventricular assist device; Open TVR: open surgical tricuspid valve replacement/repair; TTVR: transcutaneous tricuspid valve replacement/repair.

Major bleed

4.2632 (1.0269)

4.4781 (0.2580)

0.839

Cardiac arrest

1.0505 (0.4580)

2.7872 (0.1913)

< 0.001

ARDS

0 (0)

0.7294 (0.0939)

< 0.001

Cardiac tamponade

0.2127 (0.2113)

1.9164 (0.1504)

< 0.001

Pleural effusion

1.1908 (0.5212)

8.3524 (0.3403)

< 0.001

Arrhythmias

76.2786 (2.3614)

62.2894 (1.1188)

< 0.001

IABP

1.6158 (0.7511)

4.7343 (0.3247)

< 0.001

Impella

0.1907 (0.1912)

0.5093 (0.0723)

0.119

ECMO

0.7012 (0.4101)

0.7506 (0.1093)

0.907

Permanent pacemaker

4.1286 (0.9556)

12.7029 (0.5321)

< 0.001

Stroke

0.5738 (0.4165)

1.4839 (0.1282)

0.037

LVAD

0.4611 (0.3281)

1.8043 (0.2020)

< 0.001

Blood loss anemia

1.0130 (0.4428)

1.2706 (0.1410)

0.568

Infective endocarditis

3.57 (1.0050)

< 0.001

Paravalvular leak

2.36 (0.8487)

0.56 (0.0798)

0.035