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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Racial Disparities in Transcatheter Edge-to-Edge Repair Versus Open Mitral Valve Surgery: A Nationwide Analysis
Ali Awad1, Qusai Al Qudah2, Joud Fahed3
1Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
Cardiology Research
|July 29, 2026
Summary
Racial disparities persist in mitral valve interventions, with Black and Asian/Pacific Islander patients facing higher mortality. Late presentation highlights potential barriers to timely cardiovascular care for minority populations.
Area of Science:
- Cardiovascular Medicine
- Health Services Research
- Health Disparities
Background:
- Racial disparities are evident in cardiovascular care, but data on mitral valve interventions are limited.
- This study investigates racial differences in procedural selection and outcomes for mitral valve repair and surgery.
Purpose of the Study:
- To examine racial disparities in procedural selection and outcomes following transcatheter edge-to-edge repair (TEER) and open mitral valve surgery.
- To identify factors contributing to these disparities, including patient demographics, comorbidities, and presentation timing.
Main Methods:
- Analysis of the National Inpatient Sample (NIS) database from 2016-2022, including 26,456 adult patients undergoing mitral valve intervention.
- Multivariable regression models were employed to assess racial differences in mortality, procedure type, length of stay, and charges, adjusting for key covariates.
Main Results:
- Transcatheter edge-to-edge repair (TEER) constituted 89% of procedures.
- Black patients, though younger, had higher illness severity and greater odds of receiving TEER (OR=1.36).
- Adjusted analysis revealed persistent mortality disparities for Black (OR=1.49) and Asian/Pacific Islander (OR=2.20) patients. Late presentation was more frequent in Black and Hispanic patients.
Conclusions:
- Black and Asian/Pacific Islander patients experience significantly higher inpatient mortality after mitral valve intervention, unexplained by available data.
- Late referral patterns suggest systemic barriers to timely specialized cardiovascular care for minority populations.
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