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 cost-effectiveness analysis, based on the Cardiothoracic Surgical Trials Network randomised trial, compared mitral valve repair versus replacement for severe ischaemic mitral regurgitation. At 2 years, costs and QALYs were similar between approaches, but by 10 years, replacement showed a small and uncertain cost-effectiveness advantage driven by reduced cardiovascular readmissions, with continuing incremental benefit projection beyond the trial period.

UK applicability

The findings derive from United States hospital cost data and may have limited direct applicability to UK NHS settings given differences in healthcare pricing, referral pathways, and resource allocation. However, the trial methodology and comparative effectiveness framework could inform UK clinical decision-making regarding surgical approach selection.

Key measures

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

Outcomes reported

The study compared costs, quality-adjusted life years (QALYs), readmission rates, and survival outcomes between mitral valve repair and replacement 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 for long-term extrapolation
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1161/circoutcomes.117.004466
Catalogue ID
BFmovi2556-2hbr0z

Topic tags

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