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] $30,089 [$21,925 to
$48,267] versus $18,421 [$11,482 to $32,215], 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.
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Article info
Publication history
Published online: November 29, 2014
Accepted:
November 20,
2014
Received in revised form:
November 20,
2014
Received:
October 30,
2014
Footnotes
See page 485 for disclosure information.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
