J Chest Surg.  2022 Oct;55(5):388-396. 10.5090/jcs.22.016.

Trends in Heart Valve Surgery in Korea: A Report from the Heart Valve Surgery Registry Database

• Choi JW
• Kim JB
• Jung YJ
• Hwang HY
• Kim KH
• Yoo JS
• Lee S
• Lee SH
• Sung K
• Je HG
• Lim MH
• Chang BC
• Hong SC
• Lee H
• Shin YC
• Kim JH
• Lim C

• KMID: 2533508
• DOI: http://doi.org/10.5090/jcs.22.016

Abstract

Background
In this study, we present recent trends in heart valve surgery in Korea through analyses of data from the Korea Heart Valve Surgery Registry (KHVSR).
Methods
We enrolled 8,981 patients who were registered in the KHVSR from 2017 to 2020. Yearly trends in patients’ baseline characteristics, surgical profiles, and early mortality rates were explored. The observed/expected mortality ratio (O/E ratio), calculated from the actual mortality in the KHVSR and the predicted mortality estimated using the EuroSCORE II, was also analyzed.
Results
The proportion of aortic valve surgery significantly increased from 56.8% in 2017 to 60.3% in 2020. The proportion of all combined procedures and minimally invasive surgery significantly increased over the 4-year study period. The operative mortality rate was 2.9% in the entire cohort, while mitral valve repair showed the lowest mortality risk (0.9%). The mortality rates of isolated aortic valve replacement (AVR) significantly decreased from 2.1% in 2017 to 0.8% in 2020 (p=0.016). Overall, the O/E ratio was 0.784 (95% confidence interval [CI], 0.677–0.902) demonstrating significantly lower actual mortality risks than expected based on the EuroSCORE II. In particular, the O/E ratios were as low as 0.364 (95% CI, 0.208–0.591) for isolated AVR.
Conclusion
The recent data from the KHVSR showed increasing trends for complex procedures and minimally invasive surgery in heart valve surgery in Korea, and demonstrated remarkably low risks of operative mortality.

Keyword

Heart valves; Cardiac surgical procedures; Hospital mortality