Changes in the Prosthesis Types Used for Aortic Valve Replacement after the Introduction of Sutureless and Rapid Deployment Valves in Korea: A Nationwide Population-Based Cohort Study

Abstract

Background: Sutureless and rapid deployment valves for aortic valve replacement (AVR) were introduced in Korea in December 2016. This study evaluated changing trends in the prosthetic valves used for AVR in Korea after the introduction of sutureless and rapid deployment valves. Methods: From December 2016 to December 2018, 4,899 patients underwent AVR in Korea. After applying the exclusion criteria, 4,872 patients were analyzed to determine changes in the type of prosthetic valve used for AVR. The study period was divided into 5 groups corresponding to 5-month intervals. Results: The total number of AVR cases was 194.88±28.78 per month during the study period. Mechanical valves were used in approximately 27% to 33% of cases, and the proportion of mechanical valve use showed a tendency to decrease, with marginal significance overall (p=0.078) and significant decreases in patients less than 60 years of age and in men (p=0.013 and p=0.023, respectively). The use of sutureless valves increased from 13.4% to 25.8% of cases (p<0.001), especially in elderly patients (>70 years) and those requiring concomitant surgery. In a comparison between sutureless and rapid deployment valves, the use of Perceval S valves (a type of sutureless valve), gradually increased (p<0.001). Conclusion:After the introduction of sutureless and rapid deployment valves in Korea, the rate of use of these new valves remarkably increased, especially in elderly patients and those requiring concomitant surgery. Further studies should investigate the clinical outcomes of these new prostheses.

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

“…In Korea, sutureless valves and rapid-deployment valves were introduced in December 2014 and March 2016, respectively, and the Korean National Health Insurance Service began covering them in December 2016. Since then, the use of sutureless valves and rapid-deployment valves has markedly increased, especially in elderly patients and those requiring concomitant surgery [ 9 ]. In this study population, a sutureless or rapid-deployment valve in the aortic position was used in 527 patients, and the use of a sutureless or rapid-deployment valve increased significantly during the 4-year study period (p=0.017) ( Table 7 ).…”

Recent Outcomes of Surgical Redo Aortic Valve Replacement in Prosthetic Valve Failure

“…As the proportion of patients undergoing bioprosthetic AVR is increasing, 4 increasing numbers of patients are expected to require redo AVR. 5,6 Based on reports of a relatively high risk of redo surgical AVR with around 5% operative mortality, 1 ViV-TAVI has been increasingly used.…”