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Updated: Aug 31, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Surgeon versus center mitral repair volume and repair use in primary mitral regurgitation: A statewide quality
Vincenzo D Caruso1, Chang He2, Melissa J Clark2
1Division of Cardiac Surgery, St Thomas' Hospital, London, United Kingdom.
Objective:
To evaluate the relative influence of surgeon- and center-level mitral valve repair volume with repair use and early outcomes among adults undergoing isolated surgery for primary mitral regurgitation.
Methods:
Using the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (March 2011 to March 2025), we identified adults undergoing isolated mitral valve surgery for primary mitral regurgitation. High-volume centers (>50 repairs annually) and high-volume surgeons (>25 repairs over 2 consecutive years) were identified. The primary outcome was mitral valve repair versus replacement. Secondary outcomes included operative times and selected early postoperative outcomes.
Results:
Among 6649 patients who underwent mitral valve surgery, the repair rate was 80% (n = 5329). Only 3 (9%) of 33 centers and 6 (3.8%) of 146 surgeons were considered high volume. High-volume centers had greater observed repair rates (87%, n = 3027 vs 73%, n = 2302), nonsignificant after adjustment (odd ratio, 1.23; 95% CI, 0.61-2.45; P = .56). High-volume surgeons had greater adjusted repair rates (93%, n = 2613 vs 70%, n = 2716; odds ratio, 1.45; 95% CI, 1.1-1.9, P = .003), shorter median crossclamp times (75 minutes; interquartile range, 55-111 minutes vs 91 minutes; interquartile range, 71-117 minutes; P = .001), and lower permanent pacemaker implantation rates (1.0%, vs 3.0%, P < .001).
Conclusions:
In contradistinction to high-volume, greater surgeon-level mitral repair volume remained associated with greater repair use. Moreover, high- versus low-volume surgeons had shorter operative times and fewer selected early postoperative complications.
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