Black Patients Less Likely to Undergo Minimally Invasive Mitral Valve Surgery

THURSDAY, Dec. 29, 2022 (HealthDay News) — Non-Hispanic Black patients are less likely to undergo minimally invasive mitral valve surgery (MIMVS) and are more likely to die or experience a major complication than non-Hispanic White patients, according to a study published online Dec. 21 in JAMA Network Open.

Laurent G. Glance, M.D., from the University of Rochester Medical Center in New York, and colleagues used data from the Society of Thoracic Surgeons Database to identify 103,753 patients who underwent mitral valve surgery between 2014 and 2019. Racial and ethnic disparities in use of MIMVS were evaluated.

The researchers found that non-Hispanic Black individuals were less likely to undergo MIMVS (odds ratio [OR], 0.65; 95 percent confidence interval [CI], 0.58 to 0.73; P < 0.001), but Hispanic individuals were not less likely to undergo MIMVS versus non-Hispanic White individuals (OR, 1.08; 95 percent CI, 0.67 to 1.75; P = 0.74). Odds of undergoing MIMVS were higher among patients with commercial insurance (OR, 2.35; 95 percent CI, 2.06 to 2.68; P < 0.001) compared with those with Medicaid insurance and among patients operated on by very-high volume surgeons (≥300 cases; OR, 20.70; 95 percent CI, 12.7 to 33.9; P < 0.001 versus patients treated by low-volume surgeons [<20 cases]). Non-Hispanic Black individuals were still less likely to undergo MIMVS (adjusted OR, 0.88; 95 percent CI, 0.78 to 0.99; P = 0.04) and were more likely to die or experience a major complication (adjusted OR, 1.25; 95 percent CI, 1.16 to 1.35; P < 0.001) versus non-Hispanic White individuals even after adjusting for patient risk.

“These findings suggest that efforts to reduce inequity in cardiovascular medicine may need to include increasing access to private insurance and high-volume surgeons,” the authors write.