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Patients with mitral regurgitation living longer after surgery
Researchers at Yale School of Medicine have reported improved survival rates in patients undergoing mitral valve heart surgery in a study published in Circulation: Cardiovascular Quality and Outcomes.
Researchers examined 30-day readmission and 30-day and 1-year mortality rates of Medicare fee-for-service patients. All patients were aged 65 years or older and underwent mitral valve surgery from 1999 to 2008.
Overall, 30-day mortality decreased significantly from 8.1% to 4.2% from 1999 to 2008 (P<.001 for trend), indicating a relative decline of 48%. One-year mortality also declined significantly during the same time period from 15.3% to 9.2% (P=.003 for trend), a relative decline of 40%. Data also suggested a slight decline from 23% to 21% (P=.035 for trend) in 30-day readmission.
Researchers said the overall rate of mitral valve surgery declined by 9% during the study period, although the number of patients aged older than 85 years undergoing the procedure increased from 8.8% to 12.7%.
Despite significant decreases in all age, sex and race subgroups, mortality rates remained higher among those aged 85 years and older, women and nonwhite patients.
“The marked reduction in mortality after mitral valve surgery over time is an encouraging trend for cardiac surgery,” John A. Dodson, MD, a postdoctoral fellow in cardiology and geriatrics at Yale School of Medicine, said in a press release. “Although our study was not designed to identify causes for the reduction in mortality, several factors may be responsible, including improved surgical techniques, and lower rates of post-operative complications.
“There remain differences in the rate of mitral valve surgery performed, and mortality outcomes, among sex and race subgroups that deserve further investigation,” Dodson said.
Disclosure: Dr. Krumholz is the recipient of a research grant from Medtronic Inc. through Yale University and is chair of a cardiac scientific advisory board for UnitedHealth.