Valvular & structural heart diseaseCohort study
National Variation in Hospital Mitral Transcatheter Edge-to-edge Repair (MTEER) Outcomes and Correlation With Transcatheter Aortic Valve Replacement (TAVR) Outcomes
- Retrospective registry study
- national registry
- hierarchical multivariable models
Authors' conclusion
There is modest correlation between hospital-level volumes for TAVR and MTEER but low interprocedural correlation of outcomes. For similar patients, site-level variability for mortality/morbidity following MTEER was high.
Study context
- Population
- US sites offering both TAVR and MTEER, STS/ACC TVT registry, 2013–2022453 US sites
- Participants
- 384,394 vs 53,274
- Exposure
- Site-level TAVR vs MTEER volumes and outcomes
- TAVRn = 384,394
- MTEERn = 53,274
- Outcome
- Relationship between site-level volumes and adjusted outcomes for TAVR and MTEER
- Follow-up
- In-hospital and 30 days
Main finding
As reported in the abstract
- Correlation of annualized TAVR and MTEER volumes (moderate)
- r = 0.48; P < 0.001
- Sites with same decile rank for TAVR and MTEER 30-day composite outcome
- 14.3%
- Sites within 2 decile ranks
- 50.6%
- Sites with more discordant outcomes for the 2 procedures
- 35%; P = 0.0005
Observational data: associations, not effects.
Further findings
Site variability in MTEER 30-day composite outcome
| Comparison | median OR (95% CI) | |
|---|---|---|
| MTEER · 57% variability in outcome by site | 1.57 (1.51–1.64) | |
| 0.512Median odds ratio (log scale) |
Original publication
National Variation in Hospital MTEER Outcomes and Correlation With TAVR Outcomes. JACC Cardiovasc Interv. Published 7 February 2024. doi:10.1016/j.jcin.2023.11.012
Summarised from the published abstract; every number is checked against it