Abstract 1513 Comparison of costs associated with transcatheter mitral valve repair: Pascal vs MitraClip in a real-world setting

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Comparison of costs associated with transcatheter mitral valve repair: Pascal vs MitraClip in a real-world setting
J. Haurand¹, J. Haschemi¹, D. Oehler¹, F. Bönner¹, M. Kelm¹, P. Horn¹
¹Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Düsseldorf;
Aims: We aimed to compare the current two available transcatheter edge-to-edge repair (TEER) systems for the mitral valve, MitraClip and PASCAL, in terms of all upcoming costs during the TEER procedure and the associated in-hospital stay. Methods: First, we prospectively enrolled 107 TEER patients treated with either the PASCAL or MitraClip system and compared all upcoming costs during the TEER procedure and the associated in-hospital stay. Second, we retrospectively analysed 716 TEER procedures with regard to the occurrence of complications and their associated costs, includingpericardial tamponade, stroke, acute kidney injury, and vascular complications. Results: In total, 51 patients were treated using the PASCAL system, and 56 were treated using the MitraClip system. The two groups had comparable baseline characteristics and comorbidities. Additionally, the groups did not differ in terms of echocardiography-derived ventricular and valvular parameters. The total in-hospital costs were 25,414 (Interquartile range (IQR) 24631, 27697) € in the PASCAL group and 25,633 (IQR 24752, 28256) € in the MitraClip group (p=0.515). The major cost driver was initial material expenditure, mostly triggered by high valve-kit prices, which were similar to the PASCAL and MitraClip systems. The staff expenses of the catheter laboratory team were comparable for the procedures as well as expenses for accessories and supplies, resulting in comparable total procedure costs of 22,173 (IQR 22100, 22304) € in the PASCAL group and 22,200 (IQR 22100, 22304) € in the MitraClip group (p=0.565). Overall ICU costs did not differ between the PASCAL and MitraClip groups (1,469 [IQR 1469, 2938] € vs. 1,469 [IQR 1469, 1469] €, p=0.109). There was a trend toward lower general ward costs in the PASCAL group compared to the MitraClip group (1,504 [IQR 1128, 2632] € vs 2,068 [IQR 1128, 3572] €, p=0.052). Conclusion: The costs of treating patients with TEER were similar for PASCAL and MitraClip systems. The major cost drivers were valve-kit prices. TEER-related complications are rare but are associated with higher costs, mainly due to prolonged hospitalisation.
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