Related Experiment Videos
The United Kingdom Heart Valve Registry
K M Taylor1, S A Gray, S Livingstone
1Cardiothoracic Surgical Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Insights
The UK Heart Valve Registry tracked 30,000 patients from 1986-1990, noting increased aortic replacements and prosthetic valve use. Older patients (over 70) had significantly lower survival rates post-valve implant.
Area of Science:
- Cardiovascular Surgery
- Medical Registries
- Public Health Surveillance
Background:
- Established in 1986, the UK Heart Valve Registry aimed to create a national database for valve replacement surgeries.
- The project involved collaboration between the Department of Health and the Society of Cardiothoracic Surgeons.
Purpose of the Study:
- To describe the initial five years of the UK Heart Valve Registry's experience (1986-1990).
- To analyze trends in valve replacement surgery and patient demographics within the UK Health Service.
Main Methods:
- Data collection from all UK Health Service cardiac surgical units.
- Computerized database management for approximately 30,000 patient records (1986-1990).
- Mortality data validation through the Office of Population Census and Surveys (OPCS).
Main Results:
- The number of valve replacement procedures remained stable around 5,000 annually.
- Aortic valve replacements increased, while mitral valve replacements decreased.
- Prosthetic valve utilization rose from 54% to over 70%; mean patient age increased.
- Over 22% of surgeries in 1990 were on patients >70 years old.
- Five-year survival was significantly lower for patients over 70 (p < 0.005).
Conclusions:
- Significant shifts in valve replacement patterns occurred between 1986-1990.
- An aging patient population undergoing valve replacement surgery presents a challenge.
- Advanced age is associated with poorer long-term survival following valve implantation.
Abstract:
The United Kingdom Heart Valve Registry project began in 1986 following discussions between the Department of Health (DOH) and the Society of Cardiothoracic Surgeons of the United Kingdom and Ireland. The intention was to establish a computerized database for valve replacement operations carried out in the UK Health Service cardiac units. This paper describes the experience gained over the first five years of this project. Around 30,000 patients were entered in the registry between 1986 and 1990. All Uk Health Service cardiac surgical units contribute their data, which is processed by the central Registry Office. The accuracy of the mortality data is ensured by tracking the registered patients through the Office of Population Census and Surveys (OPCS). The pattern of valve replacement surgery over the period 1986-90 revealed several interesting trends. Although the number of procedures remained static at around 5,000 valve transplants per year, the number of aortic replacements increased and the number of mitrals decreased. The use of prosthetic valves increased from 54% in 1986 to over 70% in 1990. The mean age of the patients increased from 58.31 years in 1986 to 60.97 years in 1990, with over 22% of the valve replacement operations in 1990 being performed on patients over 70 years of age. The five year survival rate for patients over 70 years at the time of the valve implant is significantly lower than for patients under 70 years (p < 0.005).