Journal Article10.1016/j.jcin.2022.06.014
Reply: Could Left Atrial Function Modify Outcomes After Transcatheter Edge-to-Edge Repair of the Mitral Valve?
TL;DR: In this article , the authors used the 2017 Nationwide Readmissions Database to identify hospitals that performed at least 5 transcatheter mitral valve repair (TMVr) procedures and found no significant relationship between hospital TMVr, SMVRr, and percutaneous coronary intervention (PCI) volume and TMVR outcomes.
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Abstract: Cardiovascular procedural volumes can serve as metrics of hospital infrastructure and quality, and are the basis for thresholds for initiating transcatheter mitral valve repair (TMVr) programs. Whether hospital volumes of TMVr, surgical mitral valve replacement or repair (SMVRr), and percutaneous coronary intervention (PCI) are indicators of TMVr quality of care is not known.We used the 2017 Nationwide Readmissions Database to identify hospitals that performed at least 5 TMVr procedures. Hospitals were divided into quartiles of TMVr volume. Associations of hospital TMVr, SMVRr, and PCI volumes, as well as SMVRr and PCI outcomes with TMVr outcomes were examined. Outcomes studied were risk-standardized in-hospital mortality rate (RSMR) and 30-day readmission rate (RSRR).The study included 3404 TMVr procedures performed across 150 hospitals in the US. The median hospital TMVr volume was 17 (IQR 10, 28). The mean hospital-level RSMR and RSRR for TMVr were 3.0% (95% CI 2.5%, 3.4%) and 14.8% (95% CI 14.5%, 15.0%), respectively. There was no significant association between hospital TMVr volume (as quartiles or as a continuous variable) and TMVr RSMR or RSRR (P > 0.05). Similarly, there was weak or no correlation between hospital SMVRr and PCI volumes and outcomes with TMVr RSMR or RSRR (Pearson correlation coefficients, r = −0.199 to 0.269).In this study, we found no relationship between hospital TMVr, SMVRr, and PCI volume and TMVr outcomes. Further studies are needed to determine more appropriate structure and process measures to assess the performance of established and new TMVr centers.
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References
Long-Term Outcomes of Patients With Elevated Mitral Valve Pressure Gradient After Mitral Valve Edge-to-Edge Repair.
Benedikt Koell,Sebastian Ludwig,Jessica Weimann,Lara Waldschmidt,Annabel Hildebrandt,Niklas Schofer,Johannes Schirmer,Dirk Westermann,Hermann Reichenspurner,Stefan Blankenberg,Lenard Conradi,Edith Lubos,Daniel Kalbacher +12 more
TL;DR: In this paper , the adverse impact of elevated postprocedural mitral valve pressure gradient (MPG) on outcome in a real-world population of patients with severe mitral regurgitation (MR) who underwent transcatheter mitral repair (TEER) was investigated.
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Prognostic Value of Increased Mitral Valve Gradient After Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation.
Junghan Yoon,Moody Makar,Saibal Kar,Tarun Chakravarty,Luke Oakley,Navjot K. Sekhon,Keita Koseki,Yusuke Enta,Mamoo Nakamura,S. Hamilton,Jignesh Patel,Siddharth Singh,Sabah Skaf,Robert J. Siegel,Jeroen J. Bax,Raj Makkar +15 more
TL;DR: In this paper , the authors evaluated the prognostic value of an increased mean mitral valve pressure gradient (MVG) in patients with primary mitral regurgitation (MR) after transcatheter edge-to-edge repair (TEER).
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Impact of the MitraClip Procedure on Left Atrial Strain and Strain Rate
Esra Gucuk Ipek,Siddharth Singh,Esperanza Viloria,Ted Feldman,Paul Grayburn,Elyse Foster,Atif Qasim +6 more
TL;DR: In this paper, the authors evaluated changes in the left atrium (LA) after MitraClip placement in degenerative mitral regurgitation (MR) and compared with surgical mitral valve repair.