Temporal Trends in Mitral Valve Repair Procedures and Outcomes Among Older U.S. Adults

doi:10.1016/j.jacadv.2026.103283

Temporal Trends in Mitral Valve Repair Procedures and Outcomes Among Older U.S. Adults

JACC AdvPublished 23 Sep 2026Medicare beneficiaries undergoing mitral valve (MV) repair between 2017 and 2021 were analyzed

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Authors' conclusion

Between 2017 and 2021, M-TEER utilization increased substantially whereas surgical MV repair declined, resulting in increased overall MV repair utilization. Over the same period, adjusted short-term and midterm mortality improved despite a higher overall comorbidity index.

Study context

Population: Medicare beneficiaries undergoing MV repair between 2017 and 2021M-TEER 39,097 · surgical MV repair 42,118
Participants: 81,215 beneficiaries

Comparison: Temporal trends in procedural utilization, comorbidity burden, and mortality, with calendar year as a continuous variable
M-TEERn = 39,097
surgical MV repairn = 42,118

Methodological detailsadjusted Cox models with calendar year as a continuous variable

Adjusted Cox models with calendar year as a continuous variable

Main finding

As reported in the abstract

Procedure utilization · 2017 to 2021

M-TEER

15.0 to 27.6 per 100,000 beneficiaries (+84.0%)

Surgical MV repair

29.1 to 20.7 per 100,000

−28.9%

Overall increase in MV repair use: 9.5%

Further findings

Outcome	← Lower risk ←→ Higher risk →	aHR (95% CI)	P value
Adjusted mortality, overall, per calendar year — calendar year · 30-days · adjusted mortality decreased	0.512	0.92 (0.89–0.94)	P < 0.001
Adjusted mortality, overall, per calendar year — calendar year · postdischarge 30-days · adjusted mortality decreased	0.512	0.93 (0.89–0.97)	P < 0.001
Adjusted mortality, overall, per calendar year — calendar year · 1-year · adjusted mortality decreased	0.512	0.98 (0.97–1.00)	P = 0.013
Adjusted mortality, overall, per calendar year — calendar year · 2-years · adjusted mortality decreased	0.512	0.98 (0.97–0.99)	P < 0.001
	0.512Adjusted hazard ratio (log scale)

Outcome	M-TEER	Surgical MV repair	Estimate	P value
Elixhauser Comorbidity Index	−0.2%	−5.1%

Elixhauser Comorbidity Index — increased overall: +7.8%

Original publication

Temporal Trends in Mitral Valve Repair Procedures and Outcomes Among Older U.S. Adults. JACC Adv. Published 23 September 2026. doi:10.1016/j.jacadv.2026.103283

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Summarised from the published abstract; every number is checked against it