Related Experiment Video
Updated: May 5, 2026
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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
Published on: May 19, 2020
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Mitral Valve Repair: Optimal Annual Case Volume for Surgery
Irbaz Hameed1, Adham Ahmed1, Christina Waldron1
1Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
JACC. Advances
|February 11, 2025
Summary
Higher annual mitral valve repair (MVr) case volumes are linked to better patient outcomes. Centers performing over 38 cases annually show improved survival, while higher volumes correlate with enhanced repair durability and reduced reoperation rates.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
- Outcomes Research
Background:
- Mitral valve repair (MVr) is recommended, but repair rates and outcomes vary globally.
- Limited surgeon/center experience and care centralization challenges impact MVr consistency.
Purpose of the Study:
- To assess the association between annual case volume and long-term outcomes of isolated mitral valve repair (MVr).
Main Methods:
- Systematic literature search (Jan 2013-Nov 2023) for adult isolated MVr studies.
- Meta-analysis using reconstructed individual patient data and frailty Cox models.
- Volume-outcome relationships analyzed by pooling studies into volume tertiles.
Main Results:
- 14,070 patients from 60 studies analyzed; pooled 10-year survival was 70.8%.
- Centers performing >38 cases/year showed improved long-term survival (HR: 0.42).
- Higher volumes (>45 cases/year) improved repair durability and freedom from reoperation.
Conclusions:
- Specific annual case volumes are associated with optimal long-term outcomes in isolated MVr.
- >38 cases/year linked to better survival, >45 cases/year to improved durability, and >70 cases/year to reduced reoperation.
- Findings help define experienced centers for primary/degenerative mitral valve disease repair.
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