Universität zu Köln

Keller, Karsten ORCID: 0000-0002-0820-9584, Hobohm, Lukas, Schmidtmann, Irene, Muenzel, Thomas, Baldus, Stephan and von Bardeleben, Ralph Stephan ORCID: 0000-0002-1356-0037 (2021). Centre procedural volume and adverse in-hospital outcomes in patients undergoing percutaneous transvenous edge-to-edge mitral valve repair using MitraClip (R) in Germany. Eur. J. Heart Fail., 23 (8). S. 1380 - 1390. HOBOKEN: WILEY. ISSN 1879-0844

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Abstract

Aims The number of transcatheter mitral valve repair (TMVr) procedures has increased substantially during the last years. A better understanding of the relationship between hospital volume of transcatheter transvenous mitral valve repairs using MitraClip (R) and patient outcomes may provide information for future policy decisions to improve patient management. Methods and results We analysed patient characteristics and in-hospital outcomes for all TMVr procedures using MitraClip (R) performed in Germany from 2011 to 2017. Hospitals were stratified according to centre volumes and patients were compared for baseline characteristics and adverse in-hospital events. Overall, 24 709 inpatients were treated during the observational period. Patients treated in centres with a volume of <= 10 procedures annually developed more often pulmonary embolism (odds ratio 2.22, 95% confidence interval 1.19-4.13; P = 0.012) compared to those treated in centres with a volume of >10 procedures annually, whereas no association of centre volume (<= 10 or >10) was found with in-hospital mortality (P = 0.728). Although patients treated in centres with an annual volume >25 TMVr procedures had higher numbers of comorbidities compared to those treated in centres with an annual volume of <= 25 TMVr procedures, in-hospital mortality did not differ (3.6% vs. 3.5%, P = 0.485). Similarly, when centre volumes were stratified for <= 50 vs. >50 procedural volumes, no association with in-hospital mortality was recorded (P = 0.792). A lower rate of mitral valve surgery after MitraClip (R) was observed over time, particularly in high-volume centres. Conclusion Annual numbers of MitraClip (R) implantations increased from 2011 to 2017 in Germany, whereas in-hospital mortality remained stable. Although patients treated in high-volume centres had a more unfavourable risk profile, in-hospital mortality was comparable to that of low-volume centres.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Keller, Karsten UNSPECIFIED orcid.org/0000-0002-0820-9584 UNSPECIFIED Hobohm, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidtmann, Irene UNSPECIFIED UNSPECIFIED UNSPECIFIED Muenzel, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bardeleben, Ralph Stephan UNSPECIFIED orcid.org/0000-0002-1356-0037 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-588722
DOI:	10.1002/ejhf.2162
Journal or Publication Title:	Eur. J. Heart Fail.
Volume:	23
Number:	8
Page Range:	S. 1380 - 1390
Date:	2021
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1879-0844
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58872