{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:02:29Z","timestamp":1780315349335,"version":"3.54.1"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,2]]},"abstract":"\n Background<\/jats:title>\n \n There is an open Centers for Medicare and Medicaid Services National Coverage Decision for Transcatheter Mitral Valve Repair (\n TMV<\/jats:styled-content>\n r) and a recent multisociety consensus document suggesting that\n TMV<\/jats:styled-content>\n r centers should achieve prespecified mitral valve replacement or repair (\n MVR<\/jats:styled-content>\n r). Yet, little is known about the\n MVR<\/jats:styled-content>\n r volume\u2013\n TMV<\/jats:styled-content>\n r outcome relationship.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Using Centers for Medicare and Medicaid Services administrative claims from January 1, 2016 to December 31, 2018, we computed the Pearson correlation coefficient and performed multivariable hierarchical modeling to estimate the\n MVR<\/jats:styled-content>\n r volume to\n TMV<\/jats:styled-content>\n r outcome relationship for mortality and heart failure hospitalization. Additionally, we assessed the impact of the consensus recommendations on geographic access to care by hospital referral region. Total annualized\n MVR<\/jats:styled-content>\n r volume was <11 to 1552 (median 96, interquartile range 53, 167). One\u2010year survival, 1\u2010year heart failure hospitalization after\n TMV<\/jats:styled-content>\n r were not correlated with\n MVR<\/jats:styled-content>\n r volume. After patient risk\u2010adjustment for age, sex, and significant Elixhauser Comorbidities, there remained no significant correlation between institutional\n MVR<\/jats:styled-content>\n r volume and 1\u2010year mortality (estimate \u22120.010, SE 0.047,\n P<\/jats:italic>\n =0.834) or heart failure hospitalization (estimate \u22120.011, SE 0.045,\n P<\/jats:italic>\n =0.808) after\n TMV<\/jats:styled-content>\n r. Raising the restriction on\n TMV<\/jats:styled-content>\n r from 20 to 40\n MVR<\/jats:styled-content>\n r\/y results in \u224830\u00a0million individuals having to travel outside of their hospital referral region to undergo\n TMV<\/jats:styled-content>\n r, with a disproportionate impact in the Midwest and Southeast.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n There is no relationship between\n MVR<\/jats:styled-content>\n r volumes and\n TMV<\/jats:styled-content>\n r outcomes. Additionally, adoption of an annual\n MVR<\/jats:styled-content>\n r volume \u226540 for performance of\n TMV<\/jats:styled-content>\n r disproportionately impacts geographic access in the Midwest and Southeast and their large black and Hispanic populations.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.016140","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T09:00:13Z","timestamp":1590570013000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Mitral Valve Surgical Volume and Transcatheter Mitral Valve Repair Outcomes: Impact of a Proposed Volume Requirement on Geographic Access"],"prefix":"10.1161","volume":"9","author":[{"given":"Sreekanth","family":"Vemulapalli","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"},{"name":"Division of Cardiology Department of Medicine Duke University Medical Center Durham NC"},{"name":"Margolis Center for Healthcare Policy Duke University Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Prillinger","sequence":"additional","affiliation":[{"name":"Abbott Santa Clara CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod","family":"Thourani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Marcus Valve Center Piedmont Heart Institute Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Smith Center for Outcomes Research Institute Beth Israel Deaconess Medical Center Boston MA"},{"name":"Division of Cardiology Department of Medicine Beth Israel Deaconess Medical Center Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.08.004"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009355"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806640"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28671"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.3659"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.06.005"},{"key":"e_1_3_1_8_2","unstructured":"Census U . American Community Survey Demographic and Housing Estimates: United States Census Bureau. American Community Survey 2013\u20132017. 2019. Available at: https:\/\/www.census.gov\/\u200bacs\/www\/data\/data-tables-and-tools\/data-profiles\/2017\/. Accessed December 2019."},{"key":"e_1_3_1_9_2","unstructured":"Dartmouth Atlas of Healthcare. Appendix on the Geography of Health Care in the United States. Available at: https:\/\/www.dartmouthatlas.org\/downloads\/methods\/geogappdx.pdf. Accessed December 2019."},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000735"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.02.026"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.02.039"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.014"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1901109"},{"key":"e_1_3_1_16_2","unstructured":"Centers for Medicare and Medicaid Services . Decision Memo for Transcatheter Aortic Valve Replacement (TAVR) (CAG\u201000430N). Available at: https:\/\/www.cms.gov\/medicare-coverage-database\/details\/nca-decision-memo.aspx?NCAld=257. Accessed December 2019."},{"key":"e_1_3_1_17_2","first-page":"825","article-title":"Empirical analysis of domestic medical travel for elective cardiovascular procedures","volume":"19","author":"Langley JD","year":"2013","unstructured":"Langley JD, Johnson TJ, Hohmann SF, Meurer SJ, Garman AN. Empirical analysis of domestic medical travel for elective cardiovascular procedures. Am J Manag Care. 2013;19:825\u2013832.","journal-title":"Am J Manag Care"}],"updated-by":[{"DOI":"10.1161\/jaha.119.014560","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T00:00:00Z","timestamp":1592006400000}}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.016140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:34:36Z","timestamp":1715600076000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.016140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,2]]},"references-count":16,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,6,2]]}},"alternative-id":["10.1161\/JAHA.119.016140"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.016140","relation":{"correction":[{"id-type":"doi","id":"10.1161\/JAHA.119.014560","asserted-by":"object"}]},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,2]]},"assertion":[{"value":"2020-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e016140"}}