{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:55:23Z","timestamp":1780376123955,"version":"3.54.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,5,7]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Multidisciplinary heart team (HT) evaluation is recommended for patients with severe primary mitral regurgitation to optimize treatment decisions. However, its impact on patient outcomes remains unknown. We evaluated the impact of implementing mitral HT on patient survival.<\/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 conducted a retrospective cohort study of patients with new diagnoses of severe primary mitral regurgitation in a large healthcare network echocardiogram database between 2016 and 2020. We compared the incidence of multidisciplinary evaluation by structural cardiology and cardiac surgery services and 2\u2010year survival before and after mitral HT implementation. The 1:1 propensity\u2010score matching between pre\u2010 and post\u2010mitral HT used Society of Thoracic Surgeons Predicted Risk of Mortality for mitral repair, age, sex, race, heart failure symptoms, inpatient setting, history of MI, and dementia as covariates. Logistic regression identified variables associated with the likelihood of undergoing multidisciplinary evaluation. Among 70\u2009510 echocardiograms performed, 391 patients had severe primary mitral regurgitation (median age, 77\u2009years; 46% women). Multidisciplinary evaluation increased from 29% to 89% (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and intervention increased from 24% to 75% following mitral HT implementation (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Among 180 propensity\u2010score matched patients, mortality was lower post\u2010mitral HT at 2\u2009years (19% versus 32%,\n              <jats:italic>P<\/jats:italic>\n              =0.04). The multivariable model showed that mitral HT implementation and heart failure symptoms were associated with higher odds of undergoing multidisciplinary evaluation (OR [odds ratio], 18.7 and 2.72, respectively), whereas female sex and older age were associated with lower odds (OR, 0.39 and 0.93, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Implementation of mitral HT was associated with drastic improvement in multidisciplinary evaluation for patients with severe primary mitral regurgitation. This coincided with higher proportions of patients undergoing mechanical correction of MR and improved overall patient survival.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.033324","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T10:47:18Z","timestamp":1708685238000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Implementing Formal Mitral Heart Team Improves Multidisciplinary Evaluation Rate and Survival of Patients With Severe Primary Mitral Regurgitation"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0286-6599","authenticated-orcid":false,"given":"Christina","family":"Waldron","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery Yale University School of Medicine New Haven CT 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Cardiovascular Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1364-8055","authenticated-orcid":false,"given":"Yousif","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Kaple","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Hackensack University Medical Center Hackensack NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4079-3482","authenticated-orcid":false,"given":"John K.","family":"Forrest","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8943-9962","authenticated-orcid":false,"given":"Arnar","family":"Geirsson","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Yale University School of Medicine New Haven CT 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