Related Experiment Video
Updated: May 8, 2026
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Isolated mitral valve surgery risk in 77,836 patients from the Society of Thoracic Surgeons database
Subhasis Chatterjee1, J Scott Rankin, James S Gammie
1Affinity Health System, Appleton, Wisconsin.
Background:
Understanding the operative outcomes of mitral valve (MV) surgery across the spectrum of predicted risk of mortality (PROM) is necessary to determine the best use of novel percutaneous approaches.
Methods:
The Society of Thoracic Surgeons Adult Cardiac Surgery Database was utilized to study isolated MV operations during two time periods: era 1 (2002 to 2006, n = 37,743) and era 2 (2007 to 2010, n = 40,093). In each era, four PROM groups were defined: low risk (PROM 0% to <4%); intermediate risk (PROM 4% to <8%); high risk (PROM 8% to <12%); and extreme risk (PROM ≥ 12%). In each risk group, mortality rates and observed to expected mortality ratios were compared across eras.
Results:
A total of 63,645 cases (82%) were classified as low risk, 8,032 (10%) as intermediate risk, 2,765 (4%) as high risk, and 3,394 (4%) as extreme risk. Sixty-seven percent of MV repairs (n = 30,488) and 18% of MV replacements (n = 5,749) had a PROM less than 1%. PROM less than 4% was seen for 93% of MV repairs (n = 42,196) and 66% of replacements (n = 21,449). Across the two eras, the MV repair rate increased from 54.8% to 61.8% (p = 0.0017); and a significant reduction in operative mortality was observed in high risk and extreme risk cohorts (p < 0.05).
Conclusions:
The frequency with which MV repair for isolated MV disease is performed has increased over time and is associated with very low early mortality. A significant reduction in mortality among patients at highest risk has occurred, and must be considered as patients are evaluated for percutaneous therapies.
Insights
Mitral valve repair rates increased, showing very low early mortality. Significant reductions in operative mortality occurred for high-risk patients, informing decisions on percutaneous therapies.
Area of Science:
- Cardiac Surgery
- Cardiovascular Research
- Interventional Cardiology
Background:
- Understanding mitral valve (MV) surgery outcomes across predicted risk of mortality (PROM) spectrum is crucial.
- Novel percutaneous approaches necessitate clear operative outcome data for MV surgery.
Purpose of the Study:
- To analyze operative outcomes of mitral valve surgery based on predicted risk of mortality (PROM).
- To compare outcomes between two distinct surgical eras to identify trends and improvements.
Main Methods:
- Utilized the Society of Thoracic Surgeons Adult Cardiac Surgery Database for isolated MV operations.
- Analyzed data from two periods (2002-2006 and 2007-2010) with 37,743 and 40,093 cases, respectively.
- Stratified patients into four PROM groups (low, intermediate, high, extreme risk) and compared mortality rates and observed-to-expected mortality ratios across eras.
Main Results:
- Mitral valve repair rates increased from 54.8% to 61.8% across the study periods.
- Significant reductions in operative mortality were observed in high-risk and extreme-risk patient cohorts (p < 0.05).
- MV repair was associated with very low early mortality, with 93% of repairs having PROM < 4%.
Conclusions:
- Increased frequency of mitral valve repair for isolated MV disease is linked to very low early mortality.
- Significant mortality reduction in highest-risk patients must be considered when evaluating percutaneous therapies.
- These findings support the evolving landscape of MV disease treatment, balancing surgical and percutaneous options.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
01:22Mitral Stenosis I: Introduction
01:22Mitral Valve Prolapse II: Assessment and Management
01:19Mitral Valve Prolapse III: Nursing Management
01:27Mitral Valve Prolapse I: Introduction
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests