08:08am Wednesday 26 February 2020

Large Study Finds Higher Costs and Complications from Balloon Mitral Valvuloplasty

The study, “Balloon Mitral Valvuloplasty in United States: A 13-Year Perspective,” was recently published in The American Journal of Medicine. Led by first author Abhijit Ghatak, M.D, an interventional cardiology fellow at the University of Miami Miller School of Medicine, this study was performed using the Nationwide Inpatient Sample data from 1998 to 2010 and included weighted data on 6,540 procedures.

“Due to the shift in the paradigm of mitral valve disease in the U.S., we are now performing this procedure in older patients and those with higher burden of other diseases and so it is not surprising that we have observed a significant increase in the complication rate associated with this procedure over the last decade,” said Ghatak. “As fewer numbers of procedures are performed, it is difficult for physicians to maintain the skills needed to execute this intricate technique. In keeping with this, we observed a trend toward lower complication rates in high-volume centers and operators.”

“University of Miami Hospital is one of the premier centers in South Florida where this complex procedure is performed,” said Mauricio Cohen, M.D., associate professor of medicine in the Cardiovascular Division and one of the study co-authors. “We have the team with the required clinical expertise and medical equipment and we have an excellent track record of performing this procedure successfully.”

Senior author Eduardo de Marchena, M.D., professor of medicine and Associate Dean for International Medicine, said, “Our fellows continue to produce outstanding clinical research that helps change the practice of medicine. A study of this magnitude will be an important guide to cardiologists performing this procedure.

“We also know that complications add to the cost of hospitalization and our study clearly demonstrates this association. We noted a 100 percent increase in the hospitalization cost of this procedure in the U.S. in the last decade. Clearly procedures should be performed in experienced specialized valve and structural heart disease centers such as UMH.”

Ghatak further added, “Our study supports the recent national guidelines for structural heart disease which recommend that only specialized centers with adequate experience should perform this procedure.”

The study involved collaborations with multiple centers, including Mayo Clinic, Detroit Medical Center, Staten Island University Hospital, MedStar Washington Hospital Center, University of Pittsburgh Medical Center Shadyside Hospital, University of Arkansas for Medical Sciences, Cedars-Sinai Medical Center, Massachusetts General Hospital and Henry Ford Hospital.

Other Miller School co-authors of the study are cardiovascular fellow Vikas Singh, M.D., and interventional cardiology fellow Harit Desai, M.D.

University of Miami Miller School of Medicine

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