Current status of cardiovascular surgery in Japan, 2015 and 2016, a report based on the Japan Cardiovascular Surgery Database. 3-Valvular heart surgery

Abstract

Objectives: Data related to valvular heart surgeries from the Japan Cardiovascular Surgery Database in 2015 and 2016 were analyzed to demonstrate the associated mortality and morbidity rates and choice of surgical procedures.

Methods: We used the Japan Cardiovascular Surgery Database to extract data related to cardiac valve replacement procedures performed in 2015 and 2016. The cases were further evaluated depending upon the type of procedure and prosthesis used at each site. The percentage of bio-prosthesis usage was calculated for each valve position and age group. The rates of operative mortality and morbidity were calculated for each valve position and type of procedure.

Results: Overall, 26,054 aortic valve replacements were performed in 2015 and 2016, showing a slightly larger number than the last report (2013-2014). A total of 3305 transcatheter aortic valve replacements, 5652 mitral valve replacements and 12,024 mitral valve repair procedures were performed. The percentage of bio-prosthesis usage in aortic valve replacement was 96.5, 92.7, and 63.5% for patients in their 80s, 70s, and 60s, respectively, demonstrating an increase in usage since 2013-2014. Mechanical valves were preferred in patients on chronic hemodialysis. The mortality rates of aortic valve replacement, mitral valve replacement, mitral valve repair, and tricuspid valve replacement procedures were 4.1, 7.1, 2.2, and 10.5%, respectively.

Conclusion: We evaluated recent trends in valvular heart surgery in Japan with respect to the type of procedure and prosthesis preferred and the postoperative outcomes. We found that bio-prosthesis usage was becoming more common.

Keywords: Bio-prosthesis; Hemodialysis; Mechanical valve; Prosthetic valve selection; Surgery.