Megaphone Message: Discouraging Low-Volume Mitral Surgery
Jo Chikwe, MD, and David H. Adams, MD
Reporting outcomes research from giant datasets is like using a megaphone: Volume grabs attention whether the message is clear and important, or just white noise. Vassileva and colleagues have substantial experience working with one of the biggest megaphones in outcomes research the Medicare patient database used in their most recent report to determine whether older patients undergoing mitral surgery at low-volume centers achieve the same outcomes as patients at high-volume centers. Wide variations in mitral repair rates have been documented in the United States and elsewhere, despite the established benefits of mitral repair over replacement in terms of early and late mortality, morbidity, and quality of life. How does this latest analysis clarify optimal surgical referral?
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Publications
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2-Year Clinical and Echocardiography Follow-Up of Transcatheter Mitral Valve Replacement With the Transapical Intrepid System
Vinayak Bapat, Eric Weiss, Sean Pinney, David H Adams, Angie Zhang , Michael Mack, Martin B Leon, et al. -
Optimal timing of Ross operation in children: A moving target?
Igor E Konstantinov, Emile Bacha, David Barron, Tirone David, Joseph Dearani, Yves d'Udekem, Ismail El-Hamamsy, Hani K Najm, Pedro J Del Nido, Christian Pizarro, Peter Skillington, Vaughn A Starnes, David Winlaw -
Mitral Valve Intervention in Elderly or High-Risk Patients: A Review of Current Surgical and Interventional Management
Maheedhar Gedela, Busra Cangut, Lucy Safi, Parasuram Krishnamoorthy, Dimosthenis Pandis, Ahmed El-Eshmawi, Gilbert H L Tang -
Total artificial heart implantation as a bridge to transplantation in the United States
Shinobu Itagaki, Nana Toyoda, Natalia Egorova, Erick Sun, Timothy Lee, Percy Boateng, Gregory Gibson, Noah Moss, Donna Mancini, David H Adams, Anelechi C Anyanwu