Geographic variability and operator trends of transcatheter edge-to-edge repair in the United States.
mitral regurgitation
operator volume
procedural trends
regional disparities
transcatheter edge-to-edge repair
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 2024
01 2024
Historique:
revised:
10
08
2023
received:
12
06
2023
accepted:
06
10
2023
medline:
4
1
2024
pubmed:
19
10
2023
entrez:
19
10
2023
Statut:
ppublish
Résumé
Transcatheter edge-to-edge repair (TEER) devices are used for primary mitral regurgitation (MR) and secondary MR. Despite the growing use of TEER devices, there have not been many studies on operator experience or procedure volumes by state. We aimed to investigate nationwide operator volume trends and geographic variation in access to TEER. The United States Center for Medicare and Medicaid Services (CMS) National Medicare Provider Utilization and Payment Database (MPUPD) was analyzed between 2015 and 2020 for initial TEER procedures. Procedure volume and total operators increased yearly from 2015 to 2019 but declined in 2020. Mean annual procedure volume per operator varied significantly by state, between 0 in multiple states and 35 in North Dakota. In 2019, 994 unique operators were identified, with 295 operators documented performing 10 or more procedures (29.68%). Operators performing 10 or more TEER procedures provided 68.46% of all operations in 2019, averaging 20.94 procedures per operator. TEER procedures are becoming increasingly common as more operators are being trained. However, significant variability exists in the procedural volume per operator.
Sections du résumé
BACKGROUNDS
Transcatheter edge-to-edge repair (TEER) devices are used for primary mitral regurgitation (MR) and secondary MR. Despite the growing use of TEER devices, there have not been many studies on operator experience or procedure volumes by state.
AIMS
We aimed to investigate nationwide operator volume trends and geographic variation in access to TEER.
METHODS
The United States Center for Medicare and Medicaid Services (CMS) National Medicare Provider Utilization and Payment Database (MPUPD) was analyzed between 2015 and 2020 for initial TEER procedures.
RESULTS
Procedure volume and total operators increased yearly from 2015 to 2019 but declined in 2020. Mean annual procedure volume per operator varied significantly by state, between 0 in multiple states and 35 in North Dakota. In 2019, 994 unique operators were identified, with 295 operators documented performing 10 or more procedures (29.68%). Operators performing 10 or more TEER procedures provided 68.46% of all operations in 2019, averaging 20.94 procedures per operator.
CONCLUSIONS
TEER procedures are becoming increasingly common as more operators are being trained. However, significant variability exists in the procedural volume per operator.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
147-152Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American college of Cardiology/American heart association joint committee on clinical practice guidelines. Circulation. 2021;143(5):e72-e227. doi:10.1161/CIR.0000000000000923
Ben-Shoshan J, Overtchook P, Buithieu J, et al. Predictors of outcomes following transcatheter edge-to-edge mitral valve repair. JACC: Cardiovasc Interv. 2020;13(15):1733-1748. doi:10.1016/j.jcin.2020.03.025
Stone GW, Lindenfeld J, Abraham WT, et al. Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med. 2018;379(24):2307-2318. doi:10.1056/NEJMoa1806640
Abdelfattah OM, Saad AM, Hisung I, et al. Temporal trends of transcatheter edge-to-edge repair of the mitral valve short-term outcomes in the United States: nationwide representative study. Structural Heart. 2021;5(3):279-286. doi:10.1080/24748706.2021.1883204
Centers for Medicare and Medicaid Services. NCD-transcatheter mitral valve repair (TMVR) (20.33). Accessed March 2, 2023. https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=363&ncdver=1
Bass TA, Abbott JD, Mahmud E, et al. 2023 ACC/AHA/SCAI advanced training statement on interventional cardiology (coronary, peripheral vascular, and structural heart interventions): a report of the ACC competency management committee. Circ Cardiovasc Interv. 2023;16(0):e000088. doi:10.1161/HCV.0000000000000088
Chhatriwalla AK, Vemulapalli S, Szerlip M, et al. Operator experience and outcomes of transcatheter mitral valve repair in the United States. JACC. 2019;74(24):2955-2965. doi:10.1016/j.jacc.2019.09.014
Adamo M, Pagnesi M, Popolo Rubbio A, et al. Predictors of optimal procedural result after transcatheter edge-to-edge mitral valve repair in secondary mitral regurgitation. Catheter Cardiovasc Interv. 2022;99(5):1626-1635. doi:10.1002/ccd.30062