The influence of a percutaneous mitral repair program on surgical mitral valve volume

Emily Downs, Scott Lim, Michael Ragosta, Kenan Yount, Leora Yarboro, Ravi Ghanta, John Kern, Irving Kron, Gorav Ailawadi

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objectives Percutaneous mitral repair with the MitraClip system (Abbott Vascular, Santa Clara, Calif) has been available in trials since 2006 and is currently approved for patients with degenerative mitral valve disease at prohibitive risk for surgery. There has been concern that novel transcatheter approaches may detract from mitral valve surgical volumes. We sought to evaluate the influence of our MitraClip program on our surgical mitral valve volumes and outcomes. Methods All patients referred for MitraClip underwent evaluation by a multidisciplinary team. Patients were screened for surgical candidacy and suitable valve anatomy for transcatheter repair. The fate of patients referred for MitraClip as well as the overall surgical mitral volumes and outcomes were evaluated. Results From July 2007 to December 2014, 468 patients were referred for the MitraClip procedure at our institution. Of these, 156 patients (33.3%) received a MitraClip (including 45 implanted by surgeons), whereas 82 patients (17.5%) underwent surgical interventions. During this timeframe, the volume of isolated mitral valve operations increased from 50 procedures in 2007 to 93 in 2014 (80% increase; R2 = 0.89). Importantly, operative mortality for all patients undergoing isolated mitral surgery from 2008 to 2014 was 2.6%, with an observed to expected ratio of 0.64. Conclusions The availability of MitraClip resulted in an increase in our mitral valve referrals. Despite seeing an increase in higher risk referrals, operative mortality for mitral surgery remained excellent. Multidisciplinary evaluation, including input from experienced mitral surgeons, is necessary to have a successful percutaneous and surgical mitral valve program.

Original languageEnglish (US)
Pages (from-to)1093-1097
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume150
Issue number5
DOIs
StatePublished - Nov 2015
Externally publishedYes

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Keywords

  • cardiac catheterization
  • mitral valve

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Downs, E., Lim, S., Ragosta, M., Yount, K., Yarboro, L., Ghanta, R., Kern, J., Kron, I., & Ailawadi, G. (2015). The influence of a percutaneous mitral repair program on surgical mitral valve volume. Journal of Thoracic and Cardiovascular Surgery, 150(5), 1093-1097. https://doi.org/10.1016/j.jtcvs.2015.08.025