Trends in surgical and transcatheter interventions for tricuspid regurgitation: A national inpatient sample analysis from 2011 to 2020

Tricuspid regurgitation (TR) poses a significant health burden, with severe disease linked to poor long-term outcomes, including intractable right heart failure. Despite guidelines advocating intervention, surgical options have historically been limited due to high mortality rates. Advancements in transcatheter valve interventions (TTVI) have renewed interest in less invasive treatments. Utilizing data from the National Inpatient Sample (NIS) spanning 2011 to 2020, this study analyzed trends, factors influencing procedure selection, and outcomes of surgical and transcatheter tricuspid valve interventions across the United States. The analysis included 98,202 interventions, examining demographic and clinical disparities among patients undergoing TTVI, surgical tricuspid valve repair (STVr), and surgical tricuspid valve replacement (STVR). Between 2011 and 2020, 98,202 TV interventions were analyzed. Over time, total TV interventions increased, with TTVI peaking in 2020 (4.8 %). STVr declined from 78.20 % (2011) to 76.80 % (2020), while STVR decreased from 21.80 % to 18.40 %. Factors influencing procedure selection included age, race, hospital size, teaching status, and comorbidities. STVR accounted for the highest proportion of TV procedure-related deaths, followed by STVr and TTVI. STVR-related deaths declined over time, while STVr-related deaths increased. This study provides a helpful visual representation of mortality trends and can inform healthcare professionals about the changing landscape of TV procedure outcomes. Further analysis would be necessary to understand the underlying causes of these trends, such as changes in patient demographics, procedural volume, technology, and clinical practices over time. Central figure: National trends and predictors of utilization of transcatheter and surgical tricuspid valve procedures. [Display omitted] •Procedure Trends: Between 2011–2020, tricuspid valve interventions rose, with TTVI peaking at 4.8% in 2020, while STVr and STVR fell.•Demographic Disparities: TTVI patients were older (mean age 75.5) than STVr (53.5) and STVR (48.8), with more females and White patients.•Mortality Trends: STVR had the most deaths, followed by STVr, with TTVI remaining low. STVR deaths declined, while STVr deaths rose.•Procedural Factors: Age, race, hospital type, and comorbidities influenced procedure choice; teaching hospitals favored TTVI.•Overall Mortality Decline: Mortality for TV procedures fell from 8.26% in 2011 to 6.41%