Higher institutional volume of mitral valve (MV) surgeries may not be associated with better outcomes following transcatheter mitral valve repair (TMVr), according to results of a study presented during ACC.20/WCC and simultaneously published March 16 in JACC: Cardiovascular Interventions.

Colin M. Barker, MD, FACC, et al., examined the relationship between institutional MV procedural volumes and outcomes in Medicare patients. The researchers sought to confirm a positive relationship between institutional MV surgery volume and patient outcomes and examine whether TMVr outcomes were related to either MV surgery or TMVr institutional volumes.

Hospital volumes were categorized into three groups based on annual MV surgery volume (low, 1 to 24 procedures; medium, 25 to 39 procedures; and high, 40 or more procedures) and TMVr volume (low, 1 to 18 procedures; medium, 19 to 51 procedures; and high, 52 or more procedures). The researchers assessed outcomes by looking at in-hospital mortality, six-month post discharge mortality, and six-month cardiovascular rehospitalizations.

The results confirmed the relationship between MV surgery volume and in-hospital mortality but did not find statistically significant relationships between either MV surgery or TMVr volume and TMVr outcomes. Patients undergoing MV surgery at low- or medium-volume institutions had higher in-hospital mortality compared with those undergoing surgery at high-volume institutions.

According to the researchers, the lack of relationship between institutional MV procedure volumes and TMVr outcomes suggests that higher surgical volumes is not related to better transcatheter outcomes. The findings do not support increasing annual MV surgery volumes required to start a TMVr center, they conclude. 

Clinical Topics: Cardiac Surgery, Cardiovascular Care Team, Invasive Cardiovascular Angiography and Intervention

Keywords: acc20, ACC Annual Scientific Session, Hospital Mortality, Patient Discharge, Medicare, Mitral Valve, Cardiac Surgical Procedures, Health Facilities

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