Comparison of outcomes of balloon aortic valvuloplasty plus percutaneous coronary intervention versus percutaneous aortic balloon valvuloplasty alone during the same hospitalization in the United States.

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Citation: American Journal of Cardiology. 115(4):480-6, 2015 Feb 15.PMID: 25543235Institution: MedStar Washington Hospital CenterDepartment: Medicine/General Internal MedicineForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Multicenter StudySubject headings: *Aortic Valve Stenosis/su [Surgery] | *Balloon Valvuloplasty | *Percutaneous Coronary Intervention | Aged | Aged, 80 and over | Aortic Valve Stenosis/mo [Mortality] | Female | Hospital Mortality/td [Trends] | Humans | Length of Stay/td [Trends] | Male | Prognosis | Retrospective Studies | Survival Rate/td [Trends] | Time Factors | United States/ep [Epidemiology]Year: 2015Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0002-9149
Name of journal: The American journal of cardiologyAbstract: The use of percutaneous aortic balloon balvotomy (PABV) in high surgical risk patients has resurged because of development of less invasive endovascular therapies. We compared outcomes of concomitant PABV and percutaneous coronary intervention (PCI) with PABV alone during same hospitalization using nation's largest hospitalization database. We identified patients and determined time trends using the International Classification of Diseases, Ninth Revision, Clinical Modification, procedure code for valvulotomy from Nationwide Inpatient Sample database 1998 to 2010. Only patients >60 years with aortic stenosis were included. Primary outcome included in-hospital mortality, and secondary outcomes included procedural complications, length of stay (LOS), and cost of hospitalization. Total 2,127 PABV procedures were identified, with 247 in PABV + PCI group and 1,880 in the PABV group. Utilization rate of concomitant PABV + PCI during same hospitalization increased by 225% from 5.1% in 1998 to 1999 to 16.6% in 2009 to 2010 (p <0.001). Overall in-hospital mortality rate and complication rates in PABV + PCI group were similar to that of PABV group (10.3% vs 10.5% and 23.4% vs 24.7%, respectively). PABV + PCI group had similar LOS but higher hospitalization cost (median [interquartile range] All authors: Alfonso CE, Arora S, Badheka AO, Chothani A, Cleman M, Cohen MG, Forrest JK, Grines CL, Kliger CA, Macon C, Makkar R, Mangi A, Manvar S, O' Neill W, Panaich SS, Panchal V, Patel J, Patel N, Patel N, Patel NJ, Pfau S, Ram V, Savani GT, Schreiber T, Singh V, Solanki S, Thakkar BFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2015-04-29
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Journal Article MedStar Authors Catalog Article 25543235 Available 25543235

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

The use of percutaneous aortic balloon balvotomy (PABV) in high surgical risk patients has resurged because of development of less invasive endovascular therapies. We compared outcomes of concomitant PABV and percutaneous coronary intervention (PCI) with PABV alone during same hospitalization using nation's largest hospitalization database. We identified patients and determined time trends using the International Classification of Diseases, Ninth Revision, Clinical Modification, procedure code for valvulotomy from Nationwide Inpatient Sample database 1998 to 2010. Only patients >60 years with aortic stenosis were included. Primary outcome included in-hospital mortality, and secondary outcomes included procedural complications, length of stay (LOS), and cost of hospitalization. Total 2,127 PABV procedures were identified, with 247 in PABV + PCI group and 1,880 in the PABV group. Utilization rate of concomitant PABV + PCI during same hospitalization increased by 225% from 5.1% in 1998 to 1999 to 16.6% in 2009 to 2010 (p <0.001). Overall in-hospital mortality rate and complication rates in PABV + PCI group were similar to that of PABV group (10.3% vs 10.5% and 23.4% vs 24.7%, respectively). PABV + PCI group had similar LOS but higher hospitalization cost (median [interquartile range] 0,089 [ 1,925 to 8,267] versus 8,421 [ 1,482 to 2,215], p <0.001) in comparison with the PABV group. Unstable condition, occurrence of any complication, and weekend admission were the main predictors of increased LOS and cost of hospital admission. Concomitant PCI and PABV during the same hospitalization are not associated with change in in-hospital mortality, complications rate, or LOS compared with PABV alone; however, it increases the cost of hospitalization. Copyright � 2015 Elsevier Inc. All rights reserved.

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