Abstract 16475: Mitral Valve Transcatheter Edge to Edge Repair: A Real-World Analysis of Racial Differences in Uptake and Outcomes

Abstract

Introduction: Recently, percutaneous mitral valve transcatheter edge to edge repair (TEER) with the MitraClip system has grown as a treatment option for mitral regurgitation. However, data describing the real-world adoption of this technology are limited, especially regarding differences by race and ethnicity. Research Question: What have been the trends in usage of mitral valve TEER during its early uptake in the United States, and has there been equitable adoption across racial and ethnic groups? Methods: In a comparative study using the Veterans Affairs (VA) Clinical Assessment Reporting and Tracking database from Jan 1,2017 to Dec 31, 2022, we describe temporal changes in mitral valve TEER use within the VA system, and differences in uptake by race/ethnicity (White non-Hispanic, Black non-Hispanic, Hispanic). We further describe 30-day and 1-year mortality following TEER by race/ethnicity. Results: The rate of mitral valve TEER use increased significantly overall (p=0.008), and across each race/ethnic group studied ( Figure 1 ). However, relative to White non-Hispanic patients, Black non-Hispanic and Hispanic patients were less likely to receive mitral valve TEER (adjusted OR 0.45 [95% CI 0.28-0.70] and adjusted OR 0.47 [95% CI 0.19 -0.98] respectively) ( Figure 2 ). The adjusted 30-day and 1-year mortalities following mitral valve TEER were similar between races/ethnicities. Conclusions: Although patients benefit similarly following mitral valve TEER, adoption among non-Hispanic Black and Hispanic patients trails non-Hispanic White patients. This highlights the importance of identifying and addressing barriers to adoption among underrepresented groups.