title: Mitral Valve Repair Outcomes in a Community Hospital: A Retrospective Analysis.
abstract: BACKGROUND
  The results of mitral valve repair operations conducted at community hospitals in rural states are not well studied or reported in the literature.
  
  
  METHODS
  We retrospectively assessed consecutive patients who underwent isolated mitral valve repair operations performed by a single experienced cardiothoracic surgeon at a large community hospital from May 1, 2006 - April 30, 2010. Patients were monitored for up to three years (average 2.2 years) following surgery for a variety of surgical variables, including morbidity, mortality, and serial two-dimensional transthoracic echocardiographic findings. Comparisons were made with the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD).
  
  
  RESULTS
  Sixty-three consecutive patients underwent isolated complex mitral repair operations. Echocardiographic and morbidity data demonstrated successful outcomes, with no operative mortality and a single cardiac-related death within three years postoperatively. Other variables, especially those that relate to post-repair outcomes, showed no significant differences between our patients and comparison data from the ASCD.
  
  
  CONCLUSIONS
  Our study demonstrates equivalent risks and outcomes for complex mitral valve repair performed in a community hospital setting as those found in a national database. The appropriate institutional setting for performing highly complex procedures has substantial implications for health policy, especially regarding access and quality issues.
authors.affiliation: University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA. Electronic address: aaron.andrew.smith@my.und.edu.
authors.forename: Aaron A H
authors.initials: AA
authors.lastname: Smith
authors.affiliation: University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA; Department of Cardiothoracic Surgery, Sanford Health, Fargo, North Dakota, USA.
authors.forename: Roxanne V
authors.initials: RV
authors.lastname: Newman
authors.affiliation: Department of Research, Sanford Health, Sioux Falls, South Dakota, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Thompson
authors.affiliation: University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA; Department of Cardiology, Sanford Health, Fargo, North Dakota, USA.
authors.forename: Susan I
authors.initials: SI
authors.lastname: Farkas
authors.affiliation: University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA; Department of Cardiology, Sanford Health, Fargo, North Dakota, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Wynne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery; D058386:Mitral Valve Annuloplasty; D012189:Retrospective Studies; D012939:Social Planning
keywords: Complications; Health policy; Health professional affairs; Mitral valve repair; Surgery