Cardiovascular Events and Hospital Resource Utilization Pre and Post Transcatheter Mitral Valve Repair in High Surgical Risk Patients
Abstract Background MitraClip is an approved therapy for mitral regurgitation (MR) however, healthcare resource utilization pre and post MitraClip remains understudied. Methods and Results Patients with functional and degenerative MR at high surgical risk in the EVEREST II High-Risk Registry and REA...
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| Veröffentlicht in: | The American heart journal 2017-07, Vol.189, p.146-157 |
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| creator | Vemulapalli, Sreekanth Lippmann, Steven J Krucoff, Mitchell Hernandez, Adrian Curtis, Lesley Foster, Elyse Qasim, Atif Wang, Andrew Glower, Donald Feldman, Ted Hammill, Bradley G |
| description | Abstract Background MitraClip is an approved therapy for mitral regurgitation (MR) however, healthcare resource utilization pre and post MitraClip remains understudied. Methods and Results Patients with functional and degenerative MR at high surgical risk in the EVEREST II High-Risk Registry and REALISM Continued Access Study were linked to Medicare data. Pre- and post-MitraClip all-cause death, stroke, myocardial infarction (MI), heart failure (HF), and bleeding hospitalizations were identified. Inpatient costs, adjusted to 2010 US$, were calculated and event rate ratios and cost ratios were estimated with multivariable modeling. Among 403 linked patients, the mean age was 80 years, 60% were male, mean baseline LVEF was 49.6%, 83.3% were NYHA class III/IV, 78.2% were MR grade 3+/4+, and 63.3% had functional MR. All-cause hospitalization decreased from 1854 to 1435 / 1000 person-years, P < .001. HF hospitalization decreased following MitraClip (749 vs. 332 /1000 person-years, P < .001), but bleeding increased (199 vs 298 /1000 person-years, P < .001). Changes in stroke and MI were not statistically significant. Overall mean Medicare costs per patient were similar pre- and post-MitraClip though there was a significant decrease in mean costs among those that survived a full year after MitraClip ($18,131 [SD $25,130], vs. $11,679 [SD $22,486]; P = .02). Conclusions MitraClip was associated with a reduced rate of all-cause and HF hospitalizations and an increased rate of bleeding hospitalizations. One-year Medicare costs were reduced in those who survived a full year after the MitraClip procedure. Payors and providers seeking to reduce HF hospitalizations and associated Medicare costs may consider MitraClip among appropriate patients likely to survive 1 year. Clinical Trial Registration https://clinicaltrials.gov EVEREST II High Risk Registry (NCT-01940120) and EVEREST II REALISM (NCT-01931956). |
| doi_str_mv | 10.1016/j.ahj.2017.04.012 |
| format | Article |
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Methods and Results Patients with functional and degenerative MR at high surgical risk in the EVEREST II High-Risk Registry and REALISM Continued Access Study were linked to Medicare data. Pre- and post-MitraClip all-cause death, stroke, myocardial infarction (MI), heart failure (HF), and bleeding hospitalizations were identified. Inpatient costs, adjusted to 2010 US$, were calculated and event rate ratios and cost ratios were estimated with multivariable modeling. Among 403 linked patients, the mean age was 80 years, 60% were male, mean baseline LVEF was 49.6%, 83.3% were NYHA class III/IV, 78.2% were MR grade 3+/4+, and 63.3% had functional MR. All-cause hospitalization decreased from 1854 to 1435 / 1000 person-years, P < .001. HF hospitalization decreased following MitraClip (749 vs. 332 /1000 person-years, P < .001), but bleeding increased (199 vs 298 /1000 person-years, P < .001). Changes in stroke and MI were not statistically significant. Overall mean Medicare costs per patient were similar pre- and post-MitraClip though there was a significant decrease in mean costs among those that survived a full year after MitraClip ($18,131 [SD $25,130], vs. $11,679 [SD $22,486]; P = .02). Conclusions MitraClip was associated with a reduced rate of all-cause and HF hospitalizations and an increased rate of bleeding hospitalizations. One-year Medicare costs were reduced in those who survived a full year after the MitraClip procedure. Payors and providers seeking to reduce HF hospitalizations and associated Medicare costs may consider MitraClip among appropriate patients likely to survive 1 year. Clinical Trial Registration https://clinicaltrials.gov EVEREST II High Risk Registry (NCT-01940120) and EVEREST II REALISM (NCT-01931956).</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2017.04.012</identifier><identifier>PMID: 28625371</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bleeding ; Cardiac Catheterization - economics ; Cardiac Catheterization - methods ; Cardiovascular ; Cardiovascular system ; Catheters ; Cerebral infarction ; Costs ; Costs and Cost Analysis ; DNA repair ; Female ; Follow-Up Studies ; Government programs ; Health care ; Health Resources - utilization ; Heart ; Heart diseases ; Heart Valve Prosthesis Implantation - economics ; Heart Valve Prosthesis Implantation - methods ; Humans ; Incidence ; Male ; Medicare ; Middle Aged ; Mitral valve ; Mitral Valve - surgery ; Mitral Valve Insufficiency - economics ; Mitral Valve Insufficiency - surgery ; Mortality ; Myocardial infarction ; Patients ; Postoperative Complications - economics ; Postoperative Complications - epidemiology ; Postoperative Period ; Preoperative Period ; Prosthesis Design ; Registries ; Regurgitation ; Resource utilization ; Retrospective Studies ; Risk ; Statistical analysis ; Stroke ; Surgery ; Survival Rate - trends ; Treatment Outcome ; Ultrasonic imaging ; United States - epidemiology ; Ventricle ; Young Adult</subject><ispartof>The American heart journal, 2017-07, Vol.189, p.146-157</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 1, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-6cbabe8a6c3ac66414bb7ffec2581e6a03354df77c17398901005406a5333b5b3</citedby><cites>FETCH-LOGICAL-c436t-6cbabe8a6c3ac66414bb7ffec2581e6a03354df77c17398901005406a5333b5b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1922852767?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,64361,64363,64365,65309,72215</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28625371$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vemulapalli, Sreekanth</creatorcontrib><creatorcontrib>Lippmann, Steven J</creatorcontrib><creatorcontrib>Krucoff, Mitchell</creatorcontrib><creatorcontrib>Hernandez, Adrian</creatorcontrib><creatorcontrib>Curtis, Lesley</creatorcontrib><creatorcontrib>Foster, Elyse</creatorcontrib><creatorcontrib>Qasim, Atif</creatorcontrib><creatorcontrib>Wang, Andrew</creatorcontrib><creatorcontrib>Glower, Donald</creatorcontrib><creatorcontrib>Feldman, Ted</creatorcontrib><creatorcontrib>Hammill, Bradley G</creatorcontrib><title>Cardiovascular Events and Hospital Resource Utilization Pre and Post Transcatheter Mitral Valve Repair in High Surgical Risk Patients</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Abstract Background MitraClip is an approved therapy for mitral regurgitation (MR) however, healthcare resource utilization pre and post MitraClip remains understudied. Methods and Results Patients with functional and degenerative MR at high surgical risk in the EVEREST II High-Risk Registry and REALISM Continued Access Study were linked to Medicare data. Pre- and post-MitraClip all-cause death, stroke, myocardial infarction (MI), heart failure (HF), and bleeding hospitalizations were identified. Inpatient costs, adjusted to 2010 US$, were calculated and event rate ratios and cost ratios were estimated with multivariable modeling. Among 403 linked patients, the mean age was 80 years, 60% were male, mean baseline LVEF was 49.6%, 83.3% were NYHA class III/IV, 78.2% were MR grade 3+/4+, and 63.3% had functional MR. All-cause hospitalization decreased from 1854 to 1435 / 1000 person-years, P < .001. HF hospitalization decreased following MitraClip (749 vs. 332 /1000 person-years, P < .001), but bleeding increased (199 vs 298 /1000 person-years, P < .001). Changes in stroke and MI were not statistically significant. Overall mean Medicare costs per patient were similar pre- and post-MitraClip though there was a significant decrease in mean costs among those that survived a full year after MitraClip ($18,131 [SD $25,130], vs. $11,679 [SD $22,486]; P = .02). Conclusions MitraClip was associated with a reduced rate of all-cause and HF hospitalizations and an increased rate of bleeding hospitalizations. One-year Medicare costs were reduced in those who survived a full year after the MitraClip procedure. Payors and providers seeking to reduce HF hospitalizations and associated Medicare costs may consider MitraClip among appropriate patients likely to survive 1 year. Clinical Trial Registration https://clinicaltrials.gov EVEREST II High Risk Registry (NCT-01940120) and EVEREST II REALISM (NCT-01931956).</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bleeding</subject><subject>Cardiac Catheterization - economics</subject><subject>Cardiac Catheterization - methods</subject><subject>Cardiovascular</subject><subject>Cardiovascular system</subject><subject>Catheters</subject><subject>Cerebral infarction</subject><subject>Costs</subject><subject>Costs and Cost Analysis</subject><subject>DNA repair</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Government programs</subject><subject>Health care</subject><subject>Health Resources - utilization</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart Valve Prosthesis Implantation - economics</subject><subject>Heart Valve Prosthesis Implantation - methods</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicare</subject><subject>Middle Aged</subject><subject>Mitral valve</subject><subject>Mitral Valve - surgery</subject><subject>Mitral Valve Insufficiency - economics</subject><subject>Mitral Valve Insufficiency - surgery</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Patients</subject><subject>Postoperative Complications - economics</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Period</subject><subject>Preoperative Period</subject><subject>Prosthesis Design</subject><subject>Registries</subject><subject>Regurgitation</subject><subject>Resource utilization</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Surgery</subject><subject>Survival Rate - trends</subject><subject>Treatment Outcome</subject><subject>Ultrasonic imaging</subject><subject>United States - epidemiology</subject><subject>Ventricle</subject><subject>Young Adult</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kk9rFDEYxoModq1-AC8S8OJlxvybZAZBkKW6hRYX23oNmcw73UxnZ7ZJZqHe_d5mutVCD14SAr_nSfI8L0JvKckpofJjl5tNlzNCVU5ETih7hhaUVCqTSojnaEEIYVmpCD9Cr0Lo0lGyUr5ER2llBVd0gX4vjW_cuDfBTr3x-GQPQwzYDA1ejWHnounxDwjj5C3gq-h698tENw547eGeWo8h4ktvhmBN3EAEj89d9En20_R7SOKdcR67Aa_c9QZfTP7a2dnUhRu8Tl7zfa_Ri9b0Ad487Mfo6uvJ5XKVnX3_drr8cpZZwWXMpK1NDaWRlhsrpaCirlXbgmVFSUEawnkhmlYpSxWvyopQQgpBpCk453VR82P04eC78-PtBCHqrQsW-t4MME5B04pSWlVK8IS-f4J2KYQhvS5RjJUFU1Ilih4o68cQPLR6593W-DtNiZ470p1OHem5I02ETh0lzbsH56neQvNP8beUBHw6AJCi2DvwOtgUk4XGebBRN6P7r_3nJ2rbu2HO_AbuIDz-Qgemib6Yh2SekRQZobxk_A9XEbbJ</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Vemulapalli, Sreekanth</creator><creator>Lippmann, Steven J</creator><creator>Krucoff, Mitchell</creator><creator>Hernandez, Adrian</creator><creator>Curtis, Lesley</creator><creator>Foster, Elyse</creator><creator>Qasim, Atif</creator><creator>Wang, Andrew</creator><creator>Glower, Donald</creator><creator>Feldman, Ted</creator><creator>Hammill, Bradley G</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20170701</creationdate><title>Cardiovascular Events and Hospital Resource Utilization Pre and Post Transcatheter Mitral Valve Repair in High Surgical Risk Patients</title><author>Vemulapalli, Sreekanth ; Lippmann, Steven J ; Krucoff, Mitchell ; Hernandez, Adrian ; Curtis, Lesley ; Foster, Elyse ; Qasim, Atif ; Wang, Andrew ; Glower, Donald ; Feldman, Ted ; Hammill, Bradley G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-6cbabe8a6c3ac66414bb7ffec2581e6a03354df77c17398901005406a5333b5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bleeding</topic><topic>Cardiac Catheterization - economics</topic><topic>Cardiac Catheterization - methods</topic><topic>Cardiovascular</topic><topic>Cardiovascular system</topic><topic>Catheters</topic><topic>Cerebral infarction</topic><topic>Costs</topic><topic>Costs and Cost Analysis</topic><topic>DNA repair</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Government programs</topic><topic>Health care</topic><topic>Health Resources - utilization</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Heart Valve Prosthesis Implantation - economics</topic><topic>Heart Valve Prosthesis Implantation - methods</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicare</topic><topic>Middle Aged</topic><topic>Mitral valve</topic><topic>Mitral Valve - surgery</topic><topic>Mitral Valve Insufficiency - economics</topic><topic>Mitral Valve Insufficiency - surgery</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Patients</topic><topic>Postoperative Complications - economics</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Period</topic><topic>Preoperative Period</topic><topic>Prosthesis Design</topic><topic>Registries</topic><topic>Regurgitation</topic><topic>Resource utilization</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Surgery</topic><topic>Survival Rate - trends</topic><topic>Treatment Outcome</topic><topic>Ultrasonic imaging</topic><topic>United States - epidemiology</topic><topic>Ventricle</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vemulapalli, Sreekanth</creatorcontrib><creatorcontrib>Lippmann, Steven J</creatorcontrib><creatorcontrib>Krucoff, Mitchell</creatorcontrib><creatorcontrib>Hernandez, Adrian</creatorcontrib><creatorcontrib>Curtis, Lesley</creatorcontrib><creatorcontrib>Foster, Elyse</creatorcontrib><creatorcontrib>Qasim, Atif</creatorcontrib><creatorcontrib>Wang, Andrew</creatorcontrib><creatorcontrib>Glower, Donald</creatorcontrib><creatorcontrib>Feldman, Ted</creatorcontrib><creatorcontrib>Hammill, Bradley G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vemulapalli, Sreekanth</au><au>Lippmann, Steven J</au><au>Krucoff, Mitchell</au><au>Hernandez, Adrian</au><au>Curtis, Lesley</au><au>Foster, Elyse</au><au>Qasim, Atif</au><au>Wang, Andrew</au><au>Glower, Donald</au><au>Feldman, Ted</au><au>Hammill, Bradley G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiovascular Events and Hospital Resource Utilization Pre and Post Transcatheter Mitral Valve Repair in High Surgical Risk Patients</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>189</volume><spage>146</spage><epage>157</epage><pages>146-157</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><abstract>Abstract Background MitraClip is an approved therapy for mitral regurgitation (MR) however, healthcare resource utilization pre and post MitraClip remains understudied. Methods and Results Patients with functional and degenerative MR at high surgical risk in the EVEREST II High-Risk Registry and REALISM Continued Access Study were linked to Medicare data. Pre- and post-MitraClip all-cause death, stroke, myocardial infarction (MI), heart failure (HF), and bleeding hospitalizations were identified. Inpatient costs, adjusted to 2010 US$, were calculated and event rate ratios and cost ratios were estimated with multivariable modeling. Among 403 linked patients, the mean age was 80 years, 60% were male, mean baseline LVEF was 49.6%, 83.3% were NYHA class III/IV, 78.2% were MR grade 3+/4+, and 63.3% had functional MR. All-cause hospitalization decreased from 1854 to 1435 / 1000 person-years, P < .001. HF hospitalization decreased following MitraClip (749 vs. 332 /1000 person-years, P < .001), but bleeding increased (199 vs 298 /1000 person-years, P < .001). Changes in stroke and MI were not statistically significant. Overall mean Medicare costs per patient were similar pre- and post-MitraClip though there was a significant decrease in mean costs among those that survived a full year after MitraClip ($18,131 [SD $25,130], vs. $11,679 [SD $22,486]; P = .02). Conclusions MitraClip was associated with a reduced rate of all-cause and HF hospitalizations and an increased rate of bleeding hospitalizations. One-year Medicare costs were reduced in those who survived a full year after the MitraClip procedure. Payors and providers seeking to reduce HF hospitalizations and associated Medicare costs may consider MitraClip among appropriate patients likely to survive 1 year. Clinical Trial Registration https://clinicaltrials.gov EVEREST II High Risk Registry (NCT-01940120) and EVEREST II REALISM (NCT-01931956).</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28625371</pmid><doi>10.1016/j.ahj.2017.04.012</doi><tpages>12</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Bleeding Cardiac Catheterization - economics Cardiac Catheterization - methods Cardiovascular Cardiovascular system Catheters Cerebral infarction Costs Costs and Cost Analysis DNA repair Female Follow-Up Studies Government programs Health care Health Resources - utilization Heart Heart diseases Heart Valve Prosthesis Implantation - economics Heart Valve Prosthesis Implantation - methods Humans Incidence Male Medicare Middle Aged Mitral valve Mitral Valve - surgery Mitral Valve Insufficiency - economics Mitral Valve Insufficiency - surgery Mortality Myocardial infarction Patients Postoperative Complications - economics Postoperative Complications - epidemiology Postoperative Period Preoperative Period Prosthesis Design Registries Regurgitation Resource utilization Retrospective Studies Risk Statistical analysis Stroke Surgery Survival Rate - trends Treatment Outcome Ultrasonic imaging United States - epidemiology Ventricle Young Adult |
| title | Cardiovascular Events and Hospital Resource Utilization Pre and Post Transcatheter Mitral Valve Repair in High Surgical Risk Patients |
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