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

 Jae Woong Choi  ;  Joon Bum Kim  ;  Yoo Jin Jung  ;  Ho Young Hwang  ;  Kyung Hwan Kim  ;  Jae Suk Yoo  ;  Sak Lee  ;  Seung Hyun Lee  ;  Kiick Sung  ;  Hyung Gon Je  ;  Mi Hee Lim  ;  Byung-Chul Chang  ;  Soon Chang Hong  ;  Heemoon Lee  ;  Yoon Cheol Shin  ;  Jae Hyun Kim  ;  Cheong Lim 
 Journal of Chest Surgery, Vol.55(5) : 388-396, 2022-10 
Journal Title
Journal of Chest Surgery
Issue Date
Cardiac surgical procedures ; Heart valves ; Hospital mortality
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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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Lee, Seung Hyun(이승현) ORCID logo https://orcid.org/0000-0002-0311-6565
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