Response to Letter Regarding Article, “Influence of Hospital Procedural Volume on Care Process and Mortality for Patients Undergoing Elective Surgery for Mitral Regurgitation”
We thank Drs Shuhaiber for their interest in our work and agree that “what causes the leakage is fundamental to the outcome.” To address this fundamental connection, the Society of Thoracic Surgeons (STS) is including additional data elements in the STS National Cardiac Surgery Database that will, in addition to many other benefits, better define the underlying disease process responsible for mitral regurgitation. STS looks forward to accruing these additional data elements beginning in January 2008 and expects to be able to analyze outcomes of ischemic versus nonischemic mitral valve disease soon thereafter. For readers unfamiliar with it, the STS Adult Cardiac Database is a rich resource for analysis of risk-adjusted outcomes. It contains detailed perioperative data on >3 million surgical procedures and is estimated to include >75% of programs performing cardiothoracic surgery in the United States.