NEW YORK, NY– May 2, 2017 /Press Release/ –– Patients can maximize chances of high-quality mitral valve repair through referral to surgeons with large annual repair rates.
Surgeons who perform more than 25 mitral valve operations a year are more likely to perform repairs that are durable, and their patients are more likely to be alive a year after the operation, than when operations are performed by lower-volume surgeons, an Icahn School of Medicine at Mount Sinai study has found.
The results of the study will be presented at the American Association for Thoracic Surgery Centennial meeting on Tuesday, May 2, in Boston and published online simultaneously in the Journal of the American College of Cardiology. The study is the first to highlight that patients operated on by higher volume mitral surgeons experienced lower one year mortality and rates of reoperations compared to those operated by low volume mitral surgeons.
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Mitral valve repair is the recommended treatment for patients with severe degenerative mitral valve disease because it has important advantages over replacement, including better life expectancy and quality of life. However, among individual surgeons, huge variability exists in successful repair rates, defined as the percentage of repairs that were performed vs. replacements.
Mount Sinai researchers analyzed mitral valve surgery from the New York State Department of Health mandatory cardiac surgery database between 2002 and 2013 and found that patients whose mitral valve operations were performed by surgeons conducting more than 25 such operations per year were more likely to receive a mitral valve repair than a replacement, and the repair was more durable compared to patients operated on by surgeons with less mitral surgery experience. Patients operated on by higher-volume surgeons were also more likely to be alive a year after their surgery.
“This study adds further clarity to the American Heart Association and American College of Cardiology guidelines which already recognize that patients with degenerative mitral valve disease should be referred to experienced mitral surgeons whenever feasible,” said the study’s senior author, David H. Adams, MD, Cardiac Surgeon-in-Chief, Mount Sinai Health System, Marie-Josée and Henry R. Kravis Professor and Chairman Department of Cardiovascular Surgery Icahn School of Medicine at Mount Sinai. “Our study found for the first time that individual surgeon volume was directly linked to freedom from reoperation and survival after one year in patients operated on for degenerative mitral valve disease.”
