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Status of cardiovascular surgery in Japan between 2017 and 2018: A report based on the Japan Cardiovascular Surgery

Tomonobu Abe1, Hiraku Kumamaru2, Kiyoharu Nakano3

  • 1Division of Cardiovascular Surgery, Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan.

Asian Cardiovascular & Thoracic Annals
|January 11, 2021
PubMed

Insights

Heart valve surgery in Japan is increasing, with both surgical aortic valve replacement and transcatheter aortic valve replacement showing upward trends. Benchmark data from 2017-2018 reveals operative mortality rates for various procedures, including TAVR and SAVR.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Interventions
  • Health Database Analysis

Background:

  • Valvular heart disease necessitates surgical intervention.
  • Understanding current trends in cardiac valve surgery is crucial for healthcare planning.
  • The Japan Cardiovascular Surgery Database provides valuable insights into surgical practices.

Purpose of the Study:

  • To present current data on valvular heart surgeries in Japan for 2017-2018.
  • To analyze trends in aortic valve replacement (AVR) from 2013-2018.
  • To report operative mortality rates and minimally invasive procedure data.

Main Methods:

  • Extracted cardiac valve surgery data from the Japan Cardiovascular Surgery Database (2017-2018).
  • Calculated operative mortality rates for AVR, mitral valve repair, and mitral valve replacement (biological/mechanical prostheses).
  • Analyzed trends in AVR and data on minimally invasive procedures and transcatheter aortic valve replacement (TAVR).

Main Results:

  • Surgical aortic valve replacement (SAVR) increased from 26,054 to 28,202 cases (2017-2018), alongside a rise in TAVR.
  • Operative mortality rates: 1.8% (isolated SAVR), 0.9% (isolated mitral valve repair), 8.2% (mitral valve replacement with biological prostheses), 4.6% (mitral valve replacement with mechanical prostheses).
  • Overall mortality: 1.5% (TAVR) vs. 1.8% (SAVR). 30.8% of first-time isolated mitral valve plasty procedures used right thoracotomy, associated with better outcomes but lower risk profiles.

Conclusions:

  • Provided benchmark data for heart valve surgery in Japan for 2017-2018.
  • Highlighted increasing trends in both SAVR and TAVR.
  • Demonstrated varying operative mortality rates across different valve procedures and approaches.
Abstract

Keywords:
Aortic valveJapandatabasesfactualheart valve prosthesis implantationmitral valvetricuspid valve

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