Trends in Surgical Treatment for Valvular Heart Disease in Japan

Abstract

Purpose: The prevalence of valvular heart disease has been increasing recently, so we investigated the trends in surgical treatment in Japan.
Methods: With reference to 20 years of data (1998 to 2017) in “Thoracic and cardiovascular surgery in Japan: Annual report by the Japanese Association for Thoracic Surgery,” medical treatment data were investigated in a survey conducted by the Japanese registry of all cardiac and vascular diseases (JROAD).
Results: The number of surgeries for valvular heart disease has continually increased, reaching 23,312 in 2017, which represents a 2.6-fold increase over 20 years. Single aortic valve surgery was the most common procedure, with 10,690 such surgeries performed in 2017. The ratio of using a bioprosthesis has increased dramatically. Aortic valve replacement with a bioprosthesis, mitral valve repair and tricuspid valve repair have also increased over the years. Notably, the 30-day mortality rate has gradually decreased, reaching 1.9% in 2017.
Conclusions: The number of operations for valvular heart disease is increasing. The rate per performing aortic valve replacement with a bioprosthesis has markedly increased. Although the hospital mortality rate has not changed much in the last 10 years, the surgical results in Japan are excellent in comparison to those in other countries.