Samir V Patel1*, Nileshkumar J Patel2, Rajesh Sonani3, Sunny Jhamnani4, Palak Patel5, Sidakpal S Panaich6, Abhishek Deshmukh7 and Apurva O Badheka8
1Sparks Health Systems, USA
2University of Miami Miler School of Medicine, USA
3Brandon Regional Medical center, USA
4Yale School of Medicine, USA
5Massachusetts College of Pharmacy and Health Sciences, USA
6University of Iowa, USA
7Mayo Clinic, USA
8Everett Clinic, USA
Background: After approval by CMS, the use of Transcatheter Mitral Valve Repair (TMVR) is being adopted by many centers. The present study was conducted to compare the outcomes of surgical mitral valve repair and/or replacement among centers with and without the TMVR program.
Methods: The subjects were derived from the Nationwide Inpatient Sample (NIS) using the ICD-9- CM procedure code of 35.12, 35.23 and 35.24 in the year 2011. If any center had performed at least one TMVR procedure in the year 2011 identified by ICD-9 code 35.97 (introduced in Oct 2010), the center was considered as TMVR capable. Propensity score was used to compare outcomes of mortality, complications, complications plus mortality, length of stay (LOS), cost of hospitalization and disposition.
Results: A total of 1,598 surgical mitral valve repair/replacements were performed in 2011 with 59.82% (956) in TMVR non-capable and 40.18% (642) in TMVR capable centers. After propensity matching, TMVR capable centers had significantly lower mortality compared to TMVR non-capable centers (1.7% vs. 3.2%, p=0.0034). TMVR capable centers were also noted to have lower incidence of post-procedural complications (34.7% vs. 38.3%, p=0.019) along with higher direct disposition to home and home health care facilities (86.1% vs. 79.9%, p<0.001) but a higher hospitalization costs ($48603 vs. $42883, p<0.0001).
Conclusion: Surgical mitral valve operations have better outcomes in terms of lower in-hospital mortality, lower post-procedural complications and better discharge disposition in centers with TMVR programs.
Mitral valve surgery; TMVR; Mortality
Patel SV, Patel NJ, Sonani R, Jhamnani S, Patel P, Panaich SS, et al. The Effect of a Transcatheter Mitral Valve Repair Program on the Outcomes of Mitral Valve Surgery: A Retrospective Multicenter Study. Ann Cardiol Cardiovasc Med. 2018;2(1):1015.