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Trends in MitraClip, mitral valve repair, and mitral valve replacement from 2000 to 2016.

Authors :
Zhou S
Egorova N
Moskowitz G
Giustino G
Ailawadi G
Acker MA
Gillinov M
Moskowitz A
Gelijns A
Source :
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2021 Aug; Vol. 162 (2), pp. 551-562.e4. Date of Electronic Publication: 2020 Jan 22.
Publication Year :
2021

Abstract

Objective: The dissemination of mitral valve repair as the first-line treatment and the introduction of MitraClip for patients who have a prohibitive risk for surgery have changed the landscape of mitral valve intervention. The aim of this study is to provide current and generalizable data regarding the trend of mitral valve interventions and outcomes from 2000 to 2016.<br />Methods: Patients ≥18 years of age who underwent mitral-valve interventions were identified using the National Inpatient Sample database. National estimates were generated by means of discharge weights; comorbid conditions were identified using Elixhauser methods. All trends were analyzed with JoinPoint software.<br />Results: A total of 656,030 mitral valve interventions (298,102 mitral valve replacement, 349,053 mitral valve repair, and 8875 MitraClip) were assessed. No changes in rate of procedures (per 100,000 people in the United States) were observed over this period (annual percent change, -0.4; 95% confidence limit, -1.1 to 0.3; P = .3). From 2000 to 2010, the number of replacements decreased by 5.6% per year (P < .001), whereas repair increased by 8.4% per year from 2000 to 2006 (P < .001). MitraClip procedures increased by 84.4% annually from 2013 to 2016 (P < .001). The burden of comorbidities increased throughout the study for all groups, with the greatest score for MitraClip recipients. Overall, length of stay has decreased for all interventions, most significantly for MitraClip. In-hospital mortality decreased from 8.5% to 3.7% for all interventions, with MitraClip having the most substantial decrease from 3.6% to 1.5%.<br />Conclusions: Over a 17-year period, mitral-valve interventions were associated with improved outcomes despite being applied to an increasingly sicker population.<br /> (Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1097-685X
Volume :
162
Issue :
2
Database :
MEDLINE
Journal :
The Journal of thoracic and cardiovascular surgery
Publication Type :
Academic Journal
Accession number :
32089343
Full Text :
https://doi.org/10.1016/j.jtcvs.2019.12.097