Trends in MitraClip, mitral valve repair, and mitral valve replacement from 2000 to 2016.
Aged
Comorbidity
Databases, Factual
Female
Heart Valve Prosthesis
/ trends
Heart Valve Prosthesis Implantation
/ adverse effects
Hospital Mortality
/ trends
Humans
Inpatients
Length of Stay
/ trends
Male
Middle Aged
Mitral Valve
/ surgery
Mitral Valve Annuloplasty
/ adverse effects
Mitral Valve Insufficiency
/ diagnosis
Postoperative Complications
/ mortality
Practice Patterns, Physicians'
/ trends
Prosthesis Design
/ trends
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
United States
/ epidemiology
MitraClip
in-hospital mortality
length of stay
mitral valve repair
mitral valve replacement
surgical trends
Journal
The Journal of thoracic and cardiovascular surgery
ISSN: 1097-685X
Titre abrégé: J Thorac Cardiovasc Surg
Pays: United States
ID NLM: 0376343
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
22
05
2019
revised:
29
11
2019
accepted:
05
12
2019
pubmed:
25
2
2020
medline:
3
8
2021
entrez:
25
2
2020
Statut:
ppublish
Résumé
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. 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. 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%. Over a 17-year period, mitral-valve interventions were associated with improved outcomes despite being applied to an increasingly sicker population.
Identifiants
pubmed: 32089343
pii: S0022-5223(20)30182-3
doi: 10.1016/j.jtcvs.2019.12.097
pmc: PMC7957952
mid: NIHMS1675751
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Pagination
551-562.e4Subventions
Organisme : NHLBI NIH HHS
ID : U01 HL088942
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
Références
Med Care. 2009 Jun;47(6):626-33
pubmed: 19433995
Eur J Cardiothorac Surg. 2013 Sep;44(3):490-6; discussion 496
pubmed: 23401496
Heart Lung Circ. 2019 Feb;28(2):314-319
pubmed: 29246680
Int J Cardiol. 2017 Feb 1;228:289-294
pubmed: 27865200
N Engl J Med. 2018 Dec 13;379(24):2307-2318
pubmed: 30280640
J Am Coll Cardiol. 2017 Apr 24;:
pubmed: 28476349
Curr Treat Options Cardiovasc Med. 2009 Dec;11(6):419-25
pubmed: 19930979
Am J Cardiol. 2003 Mar 1;91(5):538-43
pubmed: 12615256
J Thorac Cardiovasc Surg. 1983 Sep;86(3):323-37
pubmed: 6887954
Med Care. 1998 Jan;36(1):8-27
pubmed: 9431328
J Am Coll Cardiol. 2014 Jul 15;64(2):182-92
pubmed: 24184254
Catheter Cardiovasc Interv. 2018 May 1;91(6):1171-1181
pubmed: 29152829
Circulation. 1995 Feb 15;91(4):1022-8
pubmed: 7850937
Circulation. 2006 Aug 1;114(5):e84-231
pubmed: 16880336
N Engl J Med. 2014 Jan 2;370(1):23-32
pubmed: 24245543
J Am Coll Cardiol. 2008 Jul 29;52(5):319-26
pubmed: 18652937
Circulation. 2019 Mar 5;139(10):e56-e528
pubmed: 30700139
J Thorac Cardiovasc Surg. 2008 Apr;135(4):885-93, 893.e1-2
pubmed: 18374775
Ann Thorac Surg. 2017 Jun;103(6):1833-1841
pubmed: 27938885
J Am Coll Cardiol. 2014 Jul 15;64(2):172-81
pubmed: 25011722
J Thorac Cardiovasc Surg. 2014 Jul;148(1):e1-e132
pubmed: 24939033
Am J Cardiol. 2017 Aug 15;120(4):708-715
pubmed: 28645469
Hypertension. 2017 Aug;70(2):275-284
pubmed: 28607131
J Clin Hypertens (Greenwich). 2014 Apr;16(4):270-6
pubmed: 24621268
BMC Cardiovasc Disord. 2017 Mar 20;17(1):85
pubmed: 28320316
JAMA. 2017 Nov 28;318(20):2011-2018
pubmed: 29183077
N Engl J Med. 2006 Jul 20;355(3):251-9
pubmed: 16855265
J Am Coll Cardiol. 2017 Jul 11;70(2):252-289
pubmed: 28315732