Mitral Valve Repair Outcomes in a Community Hospital: A Retrospective Analysis

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• 作者：Aaron A.H. Smith ; BA^a ; ^{aaron.andrew.smith@my.und.edu" class="auth_mail" title="E-mail the corresponding author} ; Roxanne V. Newman ; MD^a ; ^b ; Paul A. Thompson ; PhD^c ; Susan I. Farkas ; MD^a ; ^d ; Joshua Wynne ; MD ; MBA ; MPH^a ; ^d
• 关键词：Mitral valve repair ; Surgery ; Complications ; Health policy ; Health professional affairs
• 刊名：Heart, Lung and Circulation
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：25
• 期：5
• 页码：499-504
• 全文大小：259 K

文摘

The results of mitral valve repair operations conducted at community hospitals in rural states are not well studied or reported in the literature.

Methods

We retrospectively assessed consecutive patients who underwent isolated mitral valve repair operations performed by a single experienced cardiothoracic surgeon at a large community hospital from May 1, 2006 – April 30, 2010. Patients were monitored for up to three years (average 2.2 years) following surgery for a variety of surgical variables, including morbidity, mortality, and serial two-dimensional transthoracic echocardiographic findings. Comparisons were made with the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD).

Results

Sixty-three consecutive patients underwent isolated complex mitral repair operations. Echocardiographic and morbidity data demonstrated successful outcomes, with no operative mortality and a single cardiac-related death within three years postoperatively. Other variables, especially those that relate to post-repair outcomes, showed no significant differences between our patients and comparison data from the ASCD.

Conclusions

Our study demonstrates equivalent risks and outcomes for complex mitral valve repair performed in a community hospital setting as those found in a national database. The appropriate institutional setting for performing highly complex procedures has substantial implications for health policy, especially regarding access and quality issues.