Trends, clinical outcomes, and cost implications of mitral valve repair versus replacement, concomitant with aortic valve replacement

Abstract

Objective This study evaluated national trends, clinical outcomes, and cost implications of mitral valve (MV) repair, versus replacement, concomitant with aortic valve replacement (AVR). Methods Patients who underwent MV surgery concomitant with AVR, between 1999 and 2008, were identified in the Nationwide Inpatient Sample (NIS) registry. Mitral stenosis, endocarditis, and emergency cases were excluded. Inpatient clinical outcomes and costs were compared. Costs were derived using cost-to-charge ratios supplied by the dataset for each individual hospital. Multivariable logistic and linear regression analyses were used for risk adjustment. Results A total of 41,417 concomitant cases were identified, of which 11,472 (28%) were MV repairs. Repair rates increased from 15.3% in 1999 to 43.5% in 2008 (P