Geographic variability and operator trends of transcatheter edge-to-edge repair in the United States

Joseph Heaton, Steven Imburgio, Sowmya Dandu, Anmol Johal, Ndausung Udongwo, Anton Mararenko, Arif Asif, Jesus Almendral, Brett Sealove, Jeffrey Selan, Daniel Kiss, Matthew Saybolt

Research output: Contribution to journalArticlepeer-review


Backgrounds: Transcatheter edge-to-edge repair (TEER) devices are used for primary mitral regurgitation (MR) and secondary MR. Despite the growing use of TEER devices, there have not been many studies on operator experience or procedure volumes by state. Aims: We aimed to investigate nationwide operator volume trends and geographic variation in access to TEER. Methods: The United States Center for Medicare and Medicaid Services (CMS) National Medicare Provider Utilization and Payment Database (MPUPD) was analyzed between 2015 and 2020 for initial TEER procedures. Results: Procedure volume and total operators increased yearly from 2015 to 2019 but declined in 2020. Mean annual procedure volume per operator varied significantly by state, between 0 in multiple states and 35 in North Dakota. In 2019, 994 unique operators were identified, with 295 operators documented performing 10 or more procedures (29.68%). Operators performing 10 or more TEER procedures provided 68.46% of all operations in 2019, averaging 20.94 procedures per operator. Conclusions: TEER procedures are becoming increasingly common as more operators are being trained. However, significant variability exists in the procedural volume per operator.

Original languageEnglish
Pages (from-to)147-152
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Issue number1
StatePublished - 1 Jan 2024
Externally publishedYes


  • mitral regurgitation
  • operator volume
  • procedural trends
  • regional disparities
  • transcatheter edge-to-edge repair


Dive into the research topics of 'Geographic variability and operator trends of transcatheter edge-to-edge repair in the United States'. Together they form a unique fingerprint.

Cite this