Stephanie Anzman-Frasca, Holly Carmichael Djang, Megan M Halmo, Peter R Dolan, Christina D Economos
Estimating impacts of a breakfast in the classroom program on school outcomes
JAMA pediatrics
transcatheter mitral valve replacement tmvr garnered interest viable alternative traditional surgical mitral valve replacement smvr highrisk patients requiring redo operations study aims evaluate association tmvr selected clinical financial outcomes adults undergoing isolated redo mitral valve replacement identified 20162020 nationwide readmissions database categorized tmvr smvr cohorts various regression models developed assess association tmvr inhospital mortality well additional secondary outcomes transseptal transapical catheterbased approaches also compared relation study endpoints estimated 7725 patients 2941 381 underwent tmvr study period proportion tmvr redo operations increased 178 467 nptrend0001 following adjustment tmvr associated similar odds inhospital mortality aor 082 p 048 lower odds stroke aor 044 p 0001 prolonged ventilation aor 043 p0001 acute kidney injury aor 061 p0001 reoperation aor 029 p 002 tmvr additionally correlated shorter postoperative length stay plos 098 p0001 reduced costs 10100 p 0002 additional analysis demonstrated transseptal approach lower adjusted mortality aor 044 p 002 shorter adjusted plos 043 p0001 higher overall costs 5200 p 004 compared transapical retrospective cohort study noted tmvr yield similar odds inhospital mortality smvr fewer complications reduced healthcare expenditures moreover transseptal approaches associated lower adjusted mortality shorter plos higher cost relative transapical findings suggest tmvr represent costeffective safe treatment modality patients requiring redo mitral valve procedures nevertheless future studies examining longterm outcomes associated smvr tmvr redo mitral valve operations needed