Pulse Brain · Growing Health Evidence Index
Tier 2 — RCT / large cohortPeer-reviewed

Cost-Effectiveness of Mitral Valve Repair Versus Replacement for Severe Ischemic Mitral Regurgitation

Bart S. Ferket, Gorav Ailawadi, Annetine C. Gelijns, Michael A. Acker, Samuel F. Hohmann, Helena Chang, Denis Bouchard, David O. Meltzer, Robert E. Michler, Ellen Moquete, Pierre Voisine, John C. Mullen, Anuradha Lala, Michael J. Mack, A. Marc Gillinov, Vinod H. Thourani, Marissa A. Miller, James S. Gammie, Michael K. Parides, Emilia Bagiella, Robert L. Smith, Peter K. Smith, Judy Hung, Lopa Gupta, Eric A. Rose, Patrick T. O’Gara, Alan J. Moskowitz, for the Cardiothoracic Surgical Trials Network (CTSN) Investigators*, Wendy C. Taddei‐Peters, Dennis Buxton, Nancy L. Geller, David F. Gordon, Neal Jeffries, Albert Lee, Claudia S. Moy, Ilana Kogan Gombos, Jennifer Ralph, Richard D. Weisel, Timothy J. Gardner, Deborah D. Ascheim, Ellen Moquete, Helena Chang, Melissa Chase, James Foo, Lopa Gupta, Katherine Kirkwood, Edlira Dobrev, Ron Levitan, Karen O’Sullivan, Jessica Overbey, Milerva Santos, Deborah Williams, Paula Williams, Xia Ye, Michael J. Mack, Tracine Adame, Natalie Settele, Jenny Adams, William H. Ryan, Paul Grayburn, Frederick Y. Chen, Anju Nohria, Lawrence Cohn, Prem Shekar, Sary F. Aranki, Gregory Couper, Michael Davidson, R. Morton Bolman, Rita Lawrence, Eugene H. Blackstone, Carrie Geither, Leoma Berroteran, Diana Dolney, Kristen Doud, Suzanne Fleming, Roberta Palumbo, Christine Whitman, Kathy Sankovic, Denise Kosty Sweeney, Gregory Pattakos, Pamela A.G. Clarke, Michael Argenziano, Mathew Williams, Lyn Goldsmith, Craig R. Smith, Yoshifumi Naka, Allan Stewart, Allan Schwartz, Daniel Bell, Danielle Van Patten, Sowmyashree Sreekanth, John H. Alexander, Carmelo A. Milano, Donald D. Glower, Joseph P. Mathew, J. Kevin Harrison, Stacey Welsh, Mark F. Berry, Cyrus J. Parsa, Betty C. Tong

Circulation Cardiovascular Quality and Outcomes · 2018

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Summary

This economic evaluation of a randomised controlled trial (n=251) found no significant difference in costs or quality-adjusted life years between mitral valve repair and replacement for severe ischaemic mitral regurgitation at 2 years. Over 10 years, replacement showed marginal cost-effectiveness benefits through reduced cardiovascular readmission rates, though the uncertainty intervals were wide and the clinical and economic differences remained small and uncertain.

UK applicability

The findings may have limited direct applicability to UK practice, as the analysis was based on United States hospital costs and healthcare system structures. However, the comparative effectiveness framework and cost-effectiveness methodology could inform NHS commissioning decisions for similar cardiac interventions, subject to local cost adjustment.

Key measures

In-hospital costs, 2-year cumulative costs, quality-adjusted life years (QALYs), cardiovascular readmission rates, survival, incremental cost-effectiveness ratios

Outcomes reported

The study compared costs, quality-adjusted life years (QALYs), readmission rates, and survival outcomes between mitral valve repair and replacement for severe ischaemic mitral regurgitation over 2, 5, and 10-year time horizons.

Theme
General food systems / other
Subject
Other / interdisciplinary
Study type
Research
Study design
Economic evaluation (cost-effectiveness analysis) based on randomised controlled trial data with microsimulation extrapolation
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1161/circoutcomes.117.004466
Catalogue ID
BFmou2mger-q5wxnk

Topic tags

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