ALERT!
This site is not optimized for Internet Explorer 8 (or older).
Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.
Surgery and Transcatheter Intervention for Degenerative Mitral Regurgitation in The United States
Submitted by
Source
In this article, the authors evaluated the practice trends and three-year outcomes following transcatheter edge-to-edge repair (TEER) and surgical repair for degenerative MR in the United States. Medicare and Medicaid data of 53,117 mitral valve interventions for degenerative MR (surgery or TEER) between 2012 and 2019 were analyzed. After excluding patients with rheumatic and congenital disease, endocarditis, myocardial infarction, cardiomyopathy, and concomitant or prior coronary revascularizations, a total of 27,170 patients remained in the analysis.
The total annual volume of mitral interventions did not significantly change (p=0.18) during the study period. However, surgical cases decreased by a third while TEER increased. The included patients were 52.5 percent male and had a mean age of 73.5 years. A total of 7,755 patients underwent TEER, and 19,415 underwent surgical repair. Surgical patients were younger (p <0.001), with less comorbidity and frailty. After matching for baseline characteristics, the resulting 4,532 patient pairs presented with a three-year survival rate after TEER of 65.9 percent (95 percent CI 64.3-67.6) and 85.7 percent (95 percent CI 84.5-86.9) after surgery (p <0.001). The three-year stroke rates after TEER or surgery were 1.8 percent (95 percent CI 1.5-2.2) and 2.0 percent (95 percent CI 1.6-2.4) (p=0.49), respectively. The three-year heart failure readmission rates after TEER or surgery were 17.8 percent (95 percent CI 16.7-18.9) and 11.2 percent (95 percent CI 10.3-12.2 and p <0.001), respectively. Finally, the three-year mitral reintervention rates after TEER or surgery were 6.1 percent (95 percent CI 5.5-6.9) and 1.3 percent (95 percent CI 1.0-1.7 and p<0.001), respectively.
Comments