In the adult congenital heart disease (ACHD) population, pulmonary valve replacement (PVR) is a common intervention, its benefit, however, has been incompletely investigated. This study investigates short and intermediate-term outcomes following PVR in ACHD. Using State Inpatient Databases (SID) from the Healthcare Cost and Utilization Project we investigated both hospitalization rate and financial burden accrued over the 12-month period after PVR as compared to the 12-months before. Among 202 patients who underwent PVR, per patient-year hospitalization rates doubled in the year following PVR compared to the year prior (0.16 vs 0.36, p=0.006). With the exception of post-procedural complications, the most common reasons for hospitalization were unchanged after surgery: 22% of patients were admitted with equal or greater frequency after PVR. These patients experienced higher inpatient costs both at index admission and in the year following PVR (p = 0.004 and <0.001, respectively). Univariate predictors of increased hospitalizations post PVR were age ≥ 50 (p=0.016), transposition of the great arteries (TGA) or conotruncal abnormalities (p<0.001), lipid disorders (p=0.025), hypertension, (p=0.033), and number of chronic conditions ≥4 (p=0.004). Multivariate analysis identified TGA or conotruncal abnormalities as an independent risk factor for increased hospitalization and cost post-PVR (p=<0.001). In conclusion, short-term costs and hospitalization rates increase after PVR in a small group of ACHD patients.
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