Commentary: Trends in mitral valve interventions: The good, the bad, and the ugly

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 has 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 2000-2016. 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. RESULTS: A total of 656,030 mitral valve interventions (298,102 mitral valve replacement, 349,053 mitral valve repair, and 8,875 MitraClip) were assessed. No changes in rate of procedures (per 100,000 people in the US) were observed over this period (annual percent change=−0.4, 95% CL −1.1 to 0.3, P=0.3). From 2000-2010, the number of replacements decreased by 5.6% per year (P