TY - JOUR
T1 - Balloon mitral valvuloplasty in the United States
T2 - A 13-year perspective
AU - Badheka, Apurva O.
AU - Shah, Neeraj
AU - Ghatak, Abhijit
AU - Patel, Nileshkumar J.
AU - Chothani, Ankit
AU - Mehta, Kathan
AU - Singh, Vikas
AU - Patel, Nilay
AU - Grover, Peeyush
AU - Deshmukh, Abhishek
AU - Panaich, Sidakpal S.
AU - Savani, Ghanshyambhai T.
AU - Bhalara, Vipulkumar
AU - Arora, Shilpkumar
AU - Rathod, Ankit
AU - Desai, Harit
AU - Kar, Saibal
AU - Alfonso, Carlos
AU - Palacios, Igor F.
AU - Grines, Cindy
AU - Schreiber, Theodore
AU - Rihal, Charanjit S.
AU - Makkar, Raj
AU - Cohen, Mauricio G.
AU - O'Neill, William
AU - De Marchena, Eduardo
N1 - Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - BACKGROUND: Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. METHODS: Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for "percutaneous valvuloplasty." Patients ≥18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications. RESULTS: A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 (P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years (P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from $11,668 ± 1046 in 2001 to $23,651 ± 301 in 2010 (P <.001). CONCLUSIONS: In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years.
AB - BACKGROUND: Incidence and prevalence of mitral stenosis is declining in the US. We performed this study to determine recent trends in utilization, complications, mortality, length of stay, and cost associated with balloon mitral valvuloplasty. METHODS: Utilizing the nationwide inpatient sample database from 1998 to 2010, we identified patients using the International Classification of Diseases, 9th Revision, Clinical Modification procedure code for "percutaneous valvuloplasty." Patients ≥18 years of age with mitral stenosis were included. Patients with concomitant aortic, tricuspid, or pulmonic stenosis were excluded. Primary outcome included death and procedural complications. RESULTS: A total of 1308 balloon mitral valvuloplasties (weighted n = 6540) were analyzed. There was a 7.5% decrease in utilization of the procedure from 24.6 procedures/10 million population in 1998-2001 to 22.7 procedures/10 million population in 2008-2010 (P for trend = .098). We observed a 15.9% overall procedural complication rate and 1.7% mortality rate. The procedural complication rates have increased in recent years (P = .001), corresponding to increasing age and burden of comorbidities in patients. The mean cost per admission for balloon mitral valvuloplasty has gone up significantly over the 10 years, from $11,668 ± 1046 in 2001 to $23,651 ± 301 in 2010 (P <.001). CONCLUSIONS: In a large cross-sectional study of balloon mitral valvuloplasty in the US, we have reported trends of decreasing overall utilization and increasing procedural complication rates and cost over a period of 13 years.
KW - Balloon
KW - Complications
KW - Cost
KW - Hospital stay
KW - Mitral valve
KW - Mortality
KW - Valvuloplasty
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U2 - 10.1016/j.amjmed.2014.05.015
DO - 10.1016/j.amjmed.2014.05.015
M3 - Article
C2 - 24859718
AN - SCOPUS:84908069531
SN - 0002-9343
VL - 127
SP - 1126.e1-1126.e12
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 11
ER -