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Mitral Valve Transcatheter Edge-to-Edge Repair Volumes and Trends

Kris Kumar1,2, Timothy F Simpson1, Harsh Golwala1

  • 1Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA.

Journal of Interventional Cardiology
|December 27, 2023
PubMed
Abstract

Insights

Transcatheter edge-to-edge repair (TEER) utilization significantly increased among Medicare patients from 2015-2019. Operator procedural volumes also grew, but geographic variability in TEER use persists.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Health Services Research

Background:

  • Operator experience is linked to procedural success in transcatheter edge-to-edge repair (TEER).
  • Contemporary utilization and procedural volumes for TEER remain incompletely understood.
  • Understanding trends is crucial for optimizing patient outcomes and access to care.

Purpose of the Study:

  • To identify annual operator procedural volumes for TEER.
  • To analyze temporal trends in TEER utilization.
  • To examine geographic variability in TEER among US Medicare patients.

Main Methods:

  • Utilized the National Medicare Provider Utilization and Payment Database.
  • Analyzed data for CPT code 33418 (MitraClip) from 2015 to 2019.
  • Assessed annual operator procedural volumes, incidence, and longitudinal/geographic trends.

Main Results:

  • 27,034 TEER procedures were performed between 2015-2019.
  • Nationwide TEER incidence rose 283% (6.2 to 23.8 per 100,000 patients).
  • Significant state-level variability in TEER incidence (5.5 to 54.9 per 100,000) and mean annual operator volume (9.1 procedures in 2019) were observed.

Conclusions:

  • TEER utilization and operator procedural volumes significantly increased from 2015-2019.
  • Considerable geographic variability in TEER utilization exists across US states.
  • Further research is needed to understand the clinical impact of this variability and determine optimal procedural volumes for efficacy and access.

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