Key result
The introduction of a MitraClip program was associated with increased mitral valve replacement (43 vs. 60) and repair (110 vs. 154) volumes, alongside improved surgical outcomes.
Why the study?
Clinical trial data were not available on the institutional impact of a percutaneous mitral valve repair program on mitral valve surgery.
Does the initiation of a MitraClip program impact the volume and outcomes of mitral valve surgery at a single center?
Cohort
No
Does the initiation of a MitraClip program impact the volume and outcomes of mitral valve surgery at a single center?
The introduction of a MitraClip program at a single center was associated with increased mitral valve surgery volumes and improved surgical outcomes, suggesting a positive institutional halo effect.
Answers are grounded in this paper and cite their sources.
Should not yet change mitral valve program decisions; leaves open whether MitraClip initiation confers a surgical halo effect.
Surgical repair has been the standard therapy for severe mitral regurgitation causing symptoms or left ventricular dysfunction. Percutaneous mitral valve repair has become an appealing alternative approach for patients who are not suitable for surgery. However, clinical trial data are not available on the institutional impact of a percutaneous mitral valve repair program on mitral valve surgery. The current study retrospectively evaluated the impact of the MitraClip program on the mitral valve surgery volume and outcomes. Patient data were retrieved from the 2 years before and the 2 years after initiation of the MitraClip program. The volume of MitraClip procedures increased from eight cases in 2015 to 91 cases in 2017. Since the initiation of the MitraClip program in 2015, the volume of both mitral valve replacement and mitral valve repair also increased (43 vs. 60 and 110 vs. 154, respectively). Importantly, we observed improved surgical outcomes, including fewer perioperative complications and lower operative mortality and in-hospital mortality. Data from our single-institution experience indicate that the introduction of the MitraClip program is associated with increased mitral valve surgery volume and improved outcomes. The establishment of the MitraClip program enables the hospital to provide higher quality of care and potentially become a referring center for structural heart patients.
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Zhang et al. (2020) conducted a cohort in Severe mitral regurgitation. MitraClip program initiation vs. 2 years before initiation of the MitraClip program was evaluated on Mitral valve surgery volume and outcomes (perioperative complications, operative mortality, in-hospital mortality). The introduction of a MitraClip program was associated with increased mitral valve replacement (43 vs. 60) and repair (110 vs. 154) volumes, alongside improved surgical outcomes.
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