Percutaneous mitral valve repair in severe secondary mitral regurgitation: Analysis of index hospitalization and economic evaluation based on the MITRA-FR trial

Background. - Percutaneous mitral valve repair (pMVR) is reimbursed in France for severe secondary mitral regurgitation (SMR), but French data regarding the hospitalization index stay are lacking. Aims. - Our objectives were to describe the index hospitalization stay and to evaluate the cost of hospital stay for pMVR used in SMR. Methods. - A secondary evaluation based on patients who were randomized to the intervention group of the MITRA-FR study was undertaken. The economic evaluation was conducted according to the French hospital perspective. Medical resource use was estimated using specific data collected from patients enrolled in the MITRA-FR study and non-specific data from national statistics. Results. - The population was represented by 144 patients who underwent pMVR at 33 French centres. There was a mean +/- standard deviation of 7.9 +/- 1.5 hospital staff during procedures. The mean procedure duration was 154 +/- 68 minutes and increased with the number of implanted clips. Median total length of stay was 8 days. The occurrence of a serious adverse event was not associated with an increased risk of admission to the critical care unit, but was associated with an increased length of stay. The mean total cost was 28,025 +/- 3424 euro , which includes 21,547 euro for the cost of medical devices used during pMVR and 6478 +/- 3424 euro for other costs. Conclusion. - The cost of pMVR is substantial for patients with SMR, which advocates for further efforts to identify the patients with SMR who are likely to derive a clear clinical benefit from the procedure. (C) 2021 Elsevier Masson SAS. All rights reserved.