Why the study?
Despite the growing use of TEER devices for primary and secondary MR, few studies have examined operator experience or procedure volumes by state.
There is significant geographic variability in TEER procedural volume per operator across the United States, with a minority of operators performing the majority of procedures.
Answers are grounded in this paper and cite their sources.
Concentrated TEER volumes among few operators may signal expertise thresholds; leaves open optimal caseloads for proficiency and equitable access.
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.
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Heaton et al. (2023) studied this question.
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