Key result
Increasing institutional and operator experience with MitraClip is associated with higher rates of optimal procedural success, shorter procedure times, and decreased complication rates.
Why the study?
Transcatheter mitral valve repair with MitraClip is an intricate therapy, and understanding the relationship between procedural experience and clinical outcomes is essential given its complex learning curve.
Does increased operator and institutional experience improve procedural success and safety in transcatheter mitral valve repair with MitraClip?
Does increased operator and institutional experience improve procedural success and safety in transcatheter mitral valve repair with MitraClip?
Increasing operator and institutional experience with transcatheter mitral valve repair using MitraClip is associated with improved procedural success and safety, with the learning curve extending beyond 150 cases.
Supports experience-based referral for MitraClip; leaves open prospective validation of volume thresholds.
Transcatheter mitral valve repair with MitraClip is a novel, intricate therapy for mitral regurgitation that improves survival and quality of life. Similar to other medical procedures, there is a relationship between procedural experience and clinical outcomes. MitraClip results and the efficiency and safety of the procedure all improved with increasing experience at both the institutional and operator level in two large studies from the Society of Thoracic Surgeons and American College of Cardiology Transcatheter Valve Therapy Registry. Patient selection was also found to have a significant role in procedure success. The old adage of "See one, do one, teach one" does not necessarily apply to complex interventions, such as MitraClip, given that the learning curve does not appear to plateau even as operators approach a 150-case experience.
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Sheehy et al. (2021) conducted a review in Mitral regurgitation. Operator and institutional experience with MitraClip vs. Lower procedural volume or experience was evaluated. Increasing institutional and operator experience with MitraClip is associated with higher rates of optimal procedural success, shorter procedure times, and decreased complication rates.
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