{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:22:23Z","timestamp":1790900543727,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Transcatheter mitral valve repair (TMVr) is currently offered at selected centers that meet certain operator and institutional requirements. We sought to explore the hypothesis that the availability of TMVr is associated with improved outcomes of MV surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We used the Nationwide Readmissions Database to identify patients who underwent MV surgery at centers with or without TMVr capabilities between January 1 and December 31, 2017. The primary end point was in\u2010hospital mortality. Secondary end points were postoperative complications, resource use, and 30\u2010day readmissions. A total of 24\u00a0477 patients from 595 centers (446 TMVr, 149 non\u2010TMVr) were included. There were modest but statistically significant differences in the prevalence of comorbidities between the groups. Patients at non\u2010TMVr centers had higher unadjusted in\u2010hospital mortality than those at TMVr centers (5.6% versus 3.6%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). They also had higher rates of postoperative complications, longer hospitalizations, higher cost, and fewer home discharges but similar 30\u2010day readmission rates. After propensity matching, mortality remained higher at non\u2010TMVr centers (5.5% versus 4.0%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Rates of postoperative complications, prolonged hospitalizations, and nonhome discharges also remained higher. Postoperative mortality was consistently higher at non\u2010TMVr centers in multiple risk\u2010adjustment analyses incrementally accounting for differences in risk factors, surgical volume, availability of surgical repair, and excluding concomitant procedures. In the most comprehensive model, surgery at non\u2010TMVr centers was associated with higher odds of death (odds ratio, 1.41; 95% CI, 1.14\u20131.73;\n              <jats:italic>P<\/jats:italic>\n              =0.002).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Mitral valve surgery at TMVr centers is associated with improved in\u2010hospital outcomes compared with non\u2010TMVr centers.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019314","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T09:40:16Z","timestamp":1616492416000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Transcatheter Mitral Valve Repair Availability With Outcomes of Mitral Valve Surgery"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3847-0959","authenticated-orcid":false,"given":"Mohamad","family":"Alkhouli","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"},{"name":"Division of Cardiology Department of Medicine University of Kentucky Lexington KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram","family":"Kawsara","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine West Virginia University Morgantown WV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayra","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-5379","authenticated-orcid":false,"given":"Mackram F.","family":"Eleid","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6095-5579","authenticated-orcid":false,"given":"Vuyisile T.","family":"Nkomo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charanjit S.","family":"Rihal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Crestanello","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Mayo Clinic School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008425"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz568"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.10.022"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.09.015"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013794"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.07.002"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.09.019"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.07.051"},{"key":"e_1_3_2_10_2","first-page":"187","article-title":"Outcomes of transcatheter aortic valve replacement in patients with mitral valve regurgitation","volume":"15","author":"Abdullah O","year":"2019","unstructured":"Abdullah O, Omran J, Al\u2010Dadah A, Enezate T. 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