Operator Experience and Outcomes of Transcatheter Mitral Valve Repair in the United States

Transcatheter mitral valve repair (TMVr) for the treatment of mitral regurgitation (MR) is a complex procedure that requires development of a unique skillset. The purpose of this study was to examine the relationship between operator experience and procedural results of TMVr. TMVr device procedures...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2019-12, Vol.74 (24), p.2955-2965
Main Authors: Chhatriwalla, Adnan K., Vemulapalli, Sreekanth, Szerlip, Molly, Kodali, Susheel, Hahn, Rebecca T., Saxon, John T., Mack, Michael J., Ailawadi, Gorav, Rymer, Jennifer, Manandhar, Pratik, Kosinski, Andrzej S., Sorajja, Paul
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cardiac Surgical Procedures - adverse effects
Cardiac Surgical Procedures - instrumentation
Cardiac Surgical Procedures - statistics & numerical data
Cardiology
Clinical outcomes
Complications
Continuity (mathematics)
Endovascular Procedures - adverse effects
Endovascular Procedures - instrumentation
Endovascular Procedures - statistics & numerical data
Female
Heart
Heart surgery
Heart valves
Humans
Inflection points
Learning Curve
Learning curves
Male
mitral regurgitation
Mitral valve
Mitral Valve - surgery
Mitral Valve Insufficiency - surgery
Mortality
operator
Patients
Registries
Regurgitation
Repair
Statistical models
Success
Surgery
Thorax
Thrombosis
TMVr
Treatment Outcome
United States
Variables
Vascular surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Transcatheter mitral valve repair (TMVr) for the treatment of mitral regurgitation (MR) is a complex procedure that requires development of a unique skillset. The purpose of this study was to examine the relationship between operator experience and procedural results of TMVr. TMVr device procedures from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy registry were analyzed with operator case number as a continuous and categorical (1 to 25, 26 to 50, and >50) variable. Outcomes of procedural success, procedural time, and in-hospital procedural complications were examined. The learning curve for the procedure was evaluated using generalized linear mixed models adjusting for baseline clinical variables. All TMVr device procedures (n = 14,923) performed by 562 operators at 290 sites between November 2013 and March 2018 were analyzed. Optimal procedural success (≤1+ residual MR without death or cardiac surgery) increased across categories of operator experience (63.9%, 68.4%, and 75.1%; p 
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2019.09.014