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KMID : 1812420220550050388
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Journal of Chest Surgery
2022 Volume.55 No. 5 p.388 ~ p.396
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Trends in Heart Valve Surgery in Korea: A Report from the Heart Valve Surgery Registry Database
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Choi Jae-Woong
Kim Joon-Bum
Jung Yoo-Jin
Hwang Ho-Young
Kim Kyung-Hwan
Yoo Jae-Suk
Lee Sak
Lee Seung-Hyun
Sung Ki-Ick
Je Hyung-Gon
Lim Mi-Hee
Chang Byung-Chul
Hong Soon-Chang
Lee Hee-Moon
Shin Yoon-Cheol
Kim Jae-Hyun
Lim Cheong
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Abstract
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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.
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KEYWORD
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Heart valves, Cardiac surgical procedures, Hospital mortality
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