Balloon mitral valvuloplasty in the United States: A 13-year perspective

Apurva O. Badheka, Neeraj Shah, Abhijit Ghatak, Nileshkumar J. Patel, Ankit Chothani, Kathan Mehta, Vikas Singh, Nilay Patel, Peeyush Grover, Abhishek Deshmukh, Sidakpal S. Panaich, Ghanshyambhai T. Savani, Vipulkumar Bhalara, Shilpkumar Arora, Ankit Rathod, Harit Desai, Saibal Kar, Carlos Alfonso, Igor F. Palacios, Cindy GrinesTheodore Schreiber, Charanjit S. Rihal, Raj Makkar, Mauricio G. Cohen, William O'Neill, Eduardo De Marchena

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1126.e1-1126.e12
JournalAmerican Journal of Medicine
Volume127
Issue number11
DOIs
StatePublished - Nov 1 2014

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Keywords

  • Balloon
  • Complications
  • Cost
  • Hospital stay
  • Mitral valve
  • Mortality
  • Valvuloplasty

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Badheka, A. O., Shah, N., Ghatak, A., Patel, N. J., Chothani, A., Mehta, K., Singh, V., Patel, N., Grover, P., Deshmukh, A., Panaich, S. S., Savani, G. T., Bhalara, V., Arora, S., Rathod, A., Desai, H., Kar, S., Alfonso, C., Palacios, I. F., ... De Marchena, E. (2014). Balloon mitral valvuloplasty in the United States: A 13-year perspective. American Journal of Medicine, 127(11), 1126.e1-1126.e12. https://doi.org/10.1016/j.amjmed.2014.05.015