Document Detail


Surgery for aortic and mitral valve disease in the United States: a trend of change in surgical practice between 1998 and 2005.
MedLine Citation:
PMID:  19464459     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The surgical treatment of valvular heart disease has changed significantly in the past decade with more mitral valves being repaired and tissue valves implanted in the aortic position. The National Inpatient Sample was used to document national trends of primary isolated aortic and mitral valve surgical procedures. METHODS: Subjects were adult patients who had an isolated aortic or mitral valve repair or replacement in the United States. Estimated institution cost and total billed charges data were provided by the Centers for Medicare and Medicaid Services. RESULTS: From 1998 to 2005, an estimated 330,000 aortic or mitral valve procedures were performed in the United States (repair, n = 46,342; replacement, n = 287,989). Since 1998, annual valve repair or replacement procedures increased 186.6% and 12.6%, respectively. Aortic valve repair or replacement procedures increased 102.5% and 28.0%, respectively, with an increased percentage for repairs from 2.0% in 1998 to 3.1% in 2005. Mitral valve repair procedures increased from 18.9% in 1998 to 45.8% in 2005, with mitral replacements decreasing 17.2% over the same period. Since 1998, the total hospital billed charges for aortic valve repair procedures increased 80.6% and aortic valve replacement procedures 90.4%; mitral valve repair procedures increased from 37.8%, replacement 42.0%. Annual increases in estimated institution cost increased for both aortic and mitral procedures on average 8% to 9%. CONCLUSION: During the last decade the practice of valve surgery has changed significantly. The surgical treatment for mitral disease has transitioned to primarily one of repair, not replacement, with the use of bioprostheses more than doubled. For the aortic position, the primary procedure remained valve replacement with bioprosthesis being the valve of choice. Regardless of valve disease, institutional costs and charges for the surgical treatment have greatly outpaced physician reimbursement.
Authors:
Scott D Barnett; Niv Ad
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Publication Detail:
Type:  Journal Article     Date:  2009-02-20
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  137     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-06-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1422-9     Citation Subset:  AIM; IM    
Affiliation:
Inova Heart and Vascular Institute, Falls Church, VA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aortic Valve / surgery*
Bioprosthesis
Cardiac Surgical Procedures / trends*
Heart Valve Diseases / surgery*
Heart Valve Prosthesis Implantation / trends
Humans
Length of Stay
Middle Aged
Mitral Valve / surgery*
United States
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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