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Current status of cardiovascular surgery in Japan, 2015 and 2016, a report based on the Japan Cardiovascular Surgery
Tomonobu Abe1,2, Kiyoharu Nakano3, Norimichi Hirahara4
1Division of Cardiovascular Surgery, Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan. jcvsdo-adm@umin.net.
Insights
Bioprosthetic valve use is increasing in Japanese valvular heart surgery, especially in older patients. Mortality rates vary by procedure, with aortic valve replacement at 4.1% and mitral valve repair at 2.2%.
Area of Science:
- Cardiovascular Surgery
- Medical Device Technology
- Public Health Data Analysis
Background:
- Valvular heart disease necessitates surgical intervention, with prosthesis choice impacting patient outcomes.
- Understanding trends in surgical procedures and prosthesis selection is crucial for optimizing patient care.
- The Japan Cardiovascular Surgery Database provides valuable insights into national surgical practices.
Purpose of the Study:
- To analyze recent trends in valvular heart surgery in Japan.
- To report on mortality and morbidity rates associated with different valvular procedures.
- To examine the evolving patterns of prosthesis usage in cardiac valve surgery.
Main Methods:
- Analysis of data from the Japan Cardiovascular Surgery Database for 2015-2016.
- Evaluation of procedure types, including valve replacement and repair.
- Calculation of bioprosthesis usage percentages by valve position and age group.
- Determination of operative mortality and morbidity rates for various procedures.
Main Results:
- Over 26,000 aortic valve replacements were performed, with bioprosthesis use increasing, particularly in older age groups (e.g., 96.5% in patients in their 80s).
- Mitral valve repair was performed in over 12,000 cases, demonstrating lower mortality (2.2%) compared to mitral valve replacement (7.1%).
- Mechanical valves were the preferred choice for patients on chronic hemodialysis.
Conclusions:
- Bioprosthesis usage is a growing trend in Japanese valvular heart surgery.
- Mortality rates differ significantly across various valvular procedures, highlighting the importance of procedure selection.
- The study provides a snapshot of contemporary practices and outcomes in cardiac valve surgery in Japan.
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.
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