Current Status of Cardiovascular Surgery in Japan:Analysis of Data from Japan Cardiovascular Surgery Database in 2015, 2016. 3. Valvular Heart Surgery

Tomonobu Abe＊1	Kiyoharu Nakano2	Norimichi Hirahara3
Noboru Motomura4	Hiroaki Miyata3	Shinichi Takamoto3

（Division of Cardiovascular Surgery, Department of General Surgical Science, Graduate School of Medicine, Gunma University1, Maebashi, Japan, Harajuku Rehabilitation Hospital2, Tokyo, Japan, Department of Health Policy and Management, School of Medicine, Keio University3, Tokyo, Japan, and Department of Cardiovascular Surgery, Toho University Sakura Medical Center4, Sakura, Japan）

Objectives:Data of 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 of 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 rate of bio-prosthesis usage was derived for each valve position and age groups. The rates of operative mortality and morbidity were calculated for each valve position and type of procedures. Results:In total, 26,054 aortic valve replacements were performed in 2015 and 2016, showing a slight increase in number since the last report(2013-2014). A total of 3,305 transcatheter aortic valve replacements, 5,652 mitral valve replacements, and 12,024 mitral valve repair procedures were performed. The rate 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 the most common.

 

Jpn. J. Cardiovasc. Surg. 48:11-17（2019）

Keywords：prosthetic valve selection;mechanical valve;bioprosthesis;hemodialysis;surgery