Thorac Cardiovasc Surg 2018; 66(S 01): S1-S110
DOI: 10.1055/s-0038-1627925
Oral Presentations
Sunday, February 18, 2018
DGTHG: Catheter-based Valvular Therapies - AV Valves
Georg Thieme Verlag KG Stuttgart · New York

Insights from 8 Years of Utilization of Transcatheter Mitral Valve Repair in Germany: Observed Utilization Patterns and Impact on Overall Mitral Valve Procedure Volumes

A. Schäfer
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
E. Lubos
2   Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
,
J. B. Pietzsch
3   Wing Tech Inc., Irvine, United States
,
M. Pietzsch
4   WingTec GmbH, Karlsruhe, Germany
,
S. Weber
4   WingTec GmbH, Karlsruhe, Germany
,
S. Blankenberg
2   Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
,
H. Reichenspurner
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
U. Schäfer
2   Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
,
L. Conradi
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

 
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    Objectives: The German healthcare system was among the first to introduce transcatheter mitral valve repair (TMVR) in routine care. Objective of this study was to analyze adoption and utilization patterns and to estimate impact of TMVR availability on mitral valve (MV) procedure volumes in the first 8 years after commercialization.

    Methods: Procedure volumes at the national level were collected from German Federal Statistics Office databases for TMVR and mitral valve surgery (MVS) from 2008 to 2015. Similar data were obtained from our early-adopting center (EAC) of TMVR. Procedure volumes were stratified by age groups (< 65, 65–74, 75–84, ≥85 years).

    Results: Overall procedure volumes grew from 14,525 to 24,898 (+71%) at the national level, and from 277 to 515 (+86%) at our EAC. MVS procedures grew from 14,477 to 20,402 (+41%) and 262 to 411 (+57%), respectively. The share of TMVR procedures grew from 0.3% (48 procedures) to 18.1% (4,496 procedures) at the national level, and from 5.4% (15 procedures) to 20.2% (104 procedures) at our EAC. At the national level MVS volumes grew in all age groups, with highest growth in age < 65 (+2,945). At our EAC, MVS procedures grew in all age groups (< 65: +77.7%; 65–74: +39.4%; 75–84: +67.4%) except for age ≥85 years. In 2015, TMVR use reached 5%, 15%, 31%, and 68% of overall MV procedures in the studied age groups at the national level, compared with 4%, 13%, 44%, and 80% at the EAC. At the national level, p for trend values was 0.008, both for TMVR and MVS, and 0.345 for difference between the group growth rates. At our EAC, p for trend values was 0.208 for TMVR and 0.014 for MVS, and 0.068 for the difference between the groups.

    Conclusion: Availability of TMVR has contributed to pronounced growth in MV procedure volumes in Germany. Simultaneously, MVS procedure volumes continued to grow substantially. The highest growth of TMVR was observed in elderly populations suggesting referral of patients with MV disease previously left untreated.


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    No conflict of interest has been declared by the author(s).

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