Mitral valve repair surgery as an alternative to mitral valve replacement evaluated in Spain

04

Jan 2023

In the second half of December 2022, the Basque Office for Health Technology Assessment (OSTEBA) released a report aiming to evaluate mitral valve repair surgery as an alternative to mitral valve replacement.

The following key conclusions were provided:

  • For primary mitral insufficiency:
    • The analyzed scientific evidence described a strong advantage of valve repair versus replacement in the treatment of severe primary mitral insufficiency, namely, lower early and long-term mortality. This advantage was observed across all age groups;
    • With the exception of one study, a lower rate of reoperation was also described in patients who received mitral valve repair surgery compared to replacement;
    • No studies have been analyzed that compared the results depending on the technique of mitral valve repair;
  • For secondary mitral insufficiency:
    • The scientific evidence was insufficient to support a robust recommendation concerning valve repair versus replacement in secondary mitral insufficiency;
    • The results on the rate of reoperation were contradictory;
    • The only consistent result was the rate of admissions for heart failure during follow-up, which was less in the replacement group than in the repair group (in all considered studies);
  • According to the results of the study analyzed, there are indications that mitral valve repair surgery may be cost-effective in the short term (two years) but not in the long term (ten years), where the most cost-effective option is replacement surgery. However, no clear conclusions can be drawn concerning whether mitral valve repair is more cost-effective than mitral valve replacement due to the scarce evidence found in the economic evaluation studies.

The full details in Spanish can be found here.

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