OBJECTIVES: To identify the number and characteristics of hospitalised patients with Mitral Regurgitation (MR) using Hospital Discharge Records (SDO) in Italy.

METHODS: An observational retrospective study using Italian SDO from 2015-2019 was conducted. Patients with MR were identified by selecting all discharges with a primary diagnosis of Mitral Valve Disorders (ICD-9-CM 424.0). An algorithm based on diagnoses from previous hospitalizations classified MR as degenerative (DMR) or functional (FMR). Patients were followed for 1 year to assess the proportion undergoing surgery (SMVr) or transcatheter (TMVr) repair.

RESULTS: In 2018, from 43,136 patients discharged with MR, 10,006 patients satisfied study eligibility criteria: 7,333 (73.3%) were DMR and 2,673 (26.7%) FMR. MR was more frequent among male patients: 50.1% DMR, 63.3% FMR.

DMR patients had an average age of 65, with 45% below 65 years old, while FMR patients were older, averaging 71, with 41% over 75.

Overall, 7,180 (71.8%) patients were treated: 4,794 (47.9%) with repair (88.2% SMVr, 11.8% TMVr) and 2,386 (23.9%) with replacement procedures.

Particularly, the volume of repair procedures was 3,676 (91.6% SMVr, 8.4% TMVr) in DMR patients and 1,118 (77.1% SMVr, 22.9% TMVr) in FMR patients.

Re-intervention occurred in 1.1% of SMVr patients and in 0.5% of TMVr group.

In DMR subgroup re-intervention proportion was 0.9% (1.0% for SMVr and zero for TMVr), while in FMR was 1.5% (1.6% for SMVr, 1.2% for TMVr).

From 2015 to 2019, repair procedures increased from 43.9% to 50.1% for DMR patients and from 34.1% to 41.8% for FMR patients. The proportion of TMVr remained constant for DMR but significantly increased from 2.7% to 9.6% for FMR.

CONCLUSIONS: This study highlights the need for MR treatment in Italy and reports an increasing trend in TMVr adoption, particularly for FMR patients. The rise in TMVr use may lead to potential resources optimisation due to low post-procedural re-interventions.