Mitral Valve Operations

The mitral valve is a one-way valve between the left atrium and left ventricle, two chambers of the heart. Blood flows from the lungs into the left atrium and then through the mitral valve into the left ventricle. As the heart contracts, blood is pumped from the left ventricle to the aorta, the vessel that supplies blood to the rest of the body. At the same time, the mitral valve closes, preventing blood from flowing backwards into the left atrium.

Damage to the mitral valve can occur from a congenital defect, degenerative disease, the natural process of aging, infection, or from a heart attack. This damage can cause the valve to close improperly causing blood to flow backwards (mitral regurgitation) or to fail to fully open (mitral stenosis).

Damage to the mitral valve interferes with the normal passage of blood through the heart, and ultimately causes blood to back-up into the lungs. This can cause significant breathing problems and eventually heart failure. Operations on the mitral valve are done to repair or replace a damaged valve.

As one of the largest mitral valve programs in the country, the University of Michigan Health System treats many patients with complex mitral valve problems. Most patients with mitral valve disease are able to undergo valve repair rather than replacement. When feasible, repair of the mitral valve often results in better outcomes.

Procedure volume is the number of times a procedure was performed and is often used to assess clinical experience and expertise. The following graphs display the total number of mitral valve operations and the number of mitral valve operations for treatment of mitral regurgitation.

Total Number of Mitral Valve Operations

Details

Why is This Measure Important?

This is a measure of the volume, or number of mitral valve operations. The number includes valve repair and valve replacement procedures that are performed to treat different types of mitral valve disease. It is important to consider both volume and outcome measures when assessing quality of care.

How is UMHS Performing?

Surgeons at the University of Michigan Health System perform a substantial and increasing number of mitral valve operations. The volume is one of the highest in the nation. Though not displayed here, a vast majority of patients with mitral valve disease are able to undergo valve repair rather than replacement.

UMHS Source: University of Michigan Cardiac Surgery Clinical Database.

Number of Mitral Valve Operations for Degenerative Mitral Valve Disease

Details

Why is This Measure Important?

This is a measure of the volume, or number of mitral valve operations that are performed for patients who have degenerative mitral valve disease or mitral valve prolapse, a condition where the mitral valve fails to close properly. The mitral valve prolapse causes blood to flow backwards from the left ventricle to the left atrium when the heart contracts (mitral regurgitation). This number is a subset of the overall number of mitral valve operations performed. It is recognized that mitral valve repair rather than replacement leads to better outcomes.

How is UMHS Performing?

Surgeons at the University of Michigan Health System perform a substantial number of mitral valve operations for treatment of mitral regurgitation. The volume is one of the highest in the nation. Though not displayed here, 99.3% of patients with degenerative mitral valve disease are able to undergo valve repair rather than replacement.

UMHS Source: University of Michigan Cardiac Surgery Clinical Database.

In this section, we evaluate the success of the mitral valve operations for treatment of mitral regurgitation by measuring the mortality within 30 days after the procedure was performed.

In this graph, a lower percentage means fewer complications and better performance. The graph shows a low mortality rate for patients who underwent a mitral valve operation at the University of Michigan Health System for treatment of degenerative mitral valve disease, a condition where the mitral valve fails to close properly. The mitral valve prolapse causes blood to flow backwards from the left ventricle to the left atrium when the heart contracts (mitral regurgitation). Unfortunately, there is no national average mortality measure to which the UMHS results can be compared, but the rate of occurrence is low.

Deaths within 30 Days of Operation
Higher Value = Better Performance

Details

Why is This Measure Important?

The mortality rate is the percentage of patients who die after undergoing mitral valve operation for treatment of degenerative mitral valve disease. This is a measure of mortality rate within 30 days after the mitral valve operation. For this measure, lower percentages are better.

How is UMHS Performing?

The mortality rate is remarkably low, ranging from 0% to 2.4%, with no deaths in three of the five years.

UMHS Source: Hospital administrative data and chart review.