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. 2022 Apr 21;22(1):188.
doi: 10.1186/s12872-022-02612-x.

Clinical characteristics, outcomes and regional variations of acquired valvular heart disease patients undergoing cardiac surgery in China

Hongyuan Lin  1 , Jianfeng Hou  2 , Jiamiao Gong  1 , Yongjian Wu  1 , Zhe Zheng  1
Affiliations

Clinical characteristics, outcomes and regional variations of acquired valvular heart disease patients undergoing cardiac surgery in China

Hongyuan Lin et al. BMC Cardiovasc Disord. .

Abstract

Aims: To characterize surgical valvular heart diseases (VHDs) in China and disclose regional variations in VHD surgeries by analyzing the data derived from the Chinese Cardiac Surgery Registry (CCSR).

Methods and results: From January 2016 to December 2018, we consecutively collected the demographic information, clinical characteristics and outcomes of 38,131 adult patients undergoing valvular surgery in China. We sought to assess the quality of VHD surgery by examining in-hospital deaths of all patients from 7 geographic regions. Using a hierarchical generalized linear model, we calculated the risk-standardized mortality rate (RSMR) of each region. By comparing VHD characteristics and RSMRs, we pursued an investigation into regional variations. The mean age was 54.4 ± 12.4 years, and 47.2% of the patients were females. Among cases, the number of aortic valve surgeries was 9361 (24.5%), which was less than that of mitral valve surgeries (n = 14,506, 38.0%). The number of concurrent aortic and mitral valve surgeries was 6984 (18.3%). A total of 4529 surgical VHD patients (11.9%) also underwent coronary artery bypass grafting (CABG) surgery. The overall in-hospital mortality rate was 2.17%. The lowest RSMR, 0.91%, was found in the southwest region, and the highest RSMR, 3.99%, was found in the northeast.

Conclusion: Although the overall valvular surgical mortality rate in large Chinese cardiac centers was in line with high-income countries, there were marked regional variations in the characteristics and outcomes of surgical VHD patients across China.

Keywords: RSMR; Regional variation; Surgery; VHD; Valvular heart disease.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The summary of VHD lesion types. AS: aortic stenosis; AI: aortic insufficiency; MS: mitral stenosis; MI: mitral insufficiency; TI: tricuspid insufficiency
Fig. 2
Fig. 2
The percentages of different surgical methods and their combinations. Aortic: aortic valvular replace or repair; Mitral: mitral valvular replace or repair; CABG: coronary artery bypass grafting; Tricuspid: tricuspid valvular replace or repair
Fig. 3
Fig. 3
Each region’s sample size and observed in-hospital mortality
Fig. 4
Fig. 4
Each region’s risk standardized in-hospital mortality rate with 95% confidence interval
See this image and copyright information in PMC

References

    1. Coffey S, Roberts-Thomson R, Brown A, Carapetis J, Chen M, Enriquez-Sarano M, Zühlke L, Prendergast BD. Global epidemiology of valvular heart disease. Nat Rev Cardiol. 2021 doi: 10.1038/s41569-021-00570-z. - DOI - PubMed
    1. Liu S, Li Y, Zeng X, Wang H, Yin P, Wang L, Liu Y, Liu J, Qi J, Ran S, Yang S, Zhou M. Burden of cardiovascular diseases in China, 1990–2016: findings from the 2016 global burden of disease study. JAMA Cardiol. 2019;4(4):342–352. doi: 10.1001/jamacardio.2019.0295. - DOI - PMC - PubMed
    1. Timmis A, Vardas P, Townsend N, Torbica A, Katus H, De Smedt D, Gale C, Maggioni A, Petersen S, Huculeci R, Kazakiewicz D, de Benito Rubio V, Ignatiuk B, Raisi-Estabragh Z, Pawlak A, Karagiannidis E, Treskes R, Gaita D, Beltrame J, McConnachie A, Bardinet I, Graham I, Flather M, Elliott P, Mossialos E, Weidinger F, Achenbach S. European Society of Cardiology: cardiovascular disease statistics 2021. Eur Heart J. 2022;43:716–799. doi: 10.1093/eurheartj/ehab892. - DOI - PubMed
    1. Bowdish M, D'Agostino R, Thourani V, Schwann T, Krohn C, Desai N, Shahian D, Fernandez F, Badhwar V. STS adult cardiac surgery database: 2021 update on outcomes, quality, and research. Ann Thorac Surg. 2021;111(6):1770–1780. doi: 10.1016/j.athoracsur.2021.03.043. - DOI - PubMed
    1. Messika-Zeitoun D, Candolfi P, Vahanian A, Chan V, Enriquez-Arano M. Dismal outcomes and high societal burden of mitral valve regurgitation in France in the recent era: a nationwide perspective. J Am Heart Assoc. 2020 doi: 10.1161/JAHA.120.016086. - DOI - PMC - PubMed

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