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. 2022 Jul 2;9(7):212.
doi: 10.3390/jcdd9070212.

A Comparative Study on Surgical Treatment of Valvular Heart Disease between High-Volume Cardiac Centers in China and STS Data

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

A Comparative Study on Surgical Treatment of Valvular Heart Disease between High-Volume Cardiac Centers in China and STS Data

Hongyuan Lin et al. J Cardiovasc Dev Dis. .

Abstract

The goal of this study is to summarize valvular surgery data from the Chinese Cardiac Surgery Registry (CCSR) and compare it to the most recent data from the Society of Thoracic Surgeons (STS). From 2016 to 2018, a total of 34,386 cases of the seven most common valvular surgical procedures was obtained from the CCSR. We calculated the proportions of different procedures in the CCSR cohort (n = 34,386) as well as the change in operation volume for each procedure. We also compiled rates of postoperative in-hospital mortality and five major complications across all procedures. All of the results were compared to the STS data. The CCSR and STS data showed divergent trends in valvular heart disease features and operation volume. Although the proportion of MV repair in the CCSR (13.7%) data was lower than in the STS data (23.2%), it demonstrated a substantial upward trend. In terms of operation volume, the CCSR data showed an upward trend, but the STS data showed a downward trend. CCSR procedures showed lower mortality (2% vs. 2.6%), reoperation (2.8% vs. 4.3%), and permanent stroke (0.5% vs. 1.6%) rates than STS procedures but higher rates of prolonged ventilation (22.4% vs. 10.4%) and renal failure (5.6% vs. 3.2%). Valvular surgery quality in China's leading cardiac hospitals is roughly comparable to that in the United States. China, on the other hand, has some shortcomings that need improvement.

Keywords: CCSR; STS; VHD; quality; surgery; valvular heart disease.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Proportions of the seven most commonly performed VHD surgeries. CCSR: Chinese Cardiac Surgery Registry; STS: Society of Thoracic Surgeons; AVR: aortic valve replacement; MVR: mitral valve replacement; CABG: coronary artery bypass grafting.
Figure 2
Figure 2
Distribution of in-hospital mortality and other major complication rates (%) in different procedures. CCSR: Chinese Cardiac Surgery Registry; STS: Society of Thoracic Surgeons; AVR: aortic valve replacement; MVR: mitral valve replacement; CABG: coronary artery bypass grafting; DSWI: deep stern wound infection.
Figure 3
Figure 3
Comparison of outcomes in the whole cohort between CCSR and STS procedures. CCSR: Chinese Cardiac Surgery Registry; STS: Society of Thoracic Surgeons; DSWI: deep sternal wound infection. ***: p-value < 0.001.
Figure 4
Figure 4
Comparison of outcomes in different procedures between CCSR and STS data. CCSR: Chinese Cardiac Surgery Registry; STS: Society of Thoracic Surgeons; AVR: aortic valve replacement; MVR: mitral valve replacement; CABG: coronary artery bypass grafting; DSWI: deep sternal wound infection. *: 0.01 < p-value < 0.05; **: 0.001 < p-value < 0.01; ***: p-value < 0.001.
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