Trends and outcomes of valve surgery: 16-year results of Netherlands Cardiac Surgery National Database†

Siregar, Sabrina; Heer, Frederiek de; Groenwold, Rolf H H; Versteegh, Michel I.M.; Bekkers, Jos A.; Brinkman, Emile S.; Bots, Michiel L.; Graaf, Yolanda van der; Herwerden, Lex A. van

doi:10.1093/ejcts/ezu017

Cited by 60 publications

(35 citation statements)

References 17 publications

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“…In the past 15 years, there has been a substantial increase in the number of heart valve surgeries in Spain. This increase is in line with the trend observed in other European countries and in the United States [3,6,10,11] . A retrospective study found that the number of procedures increased from 47.5 to 88.9 per 100,000 Medicare beneficiaries between 2009 and 2015 [11] .…”

Section: Discussionsupporting

confidence: 91%

“…A study using NIS found an increase in bioprosthetic valve use from 37.7% in 1998-2001 to 63.6% in 2007-2011 [4] . This trend has also been reported in other registries [3,6,10,16] and suggested improved durability of biological prostheses, fewer neurological and functional complications and avoidance of permanent anticoagulation [12,17] . Lastly, technological advances such as the valve-in-valve transcatheter procedure provided new alternatives for reoperations in biological prostheses [10] .…”

Section: Factors Associated With Ihm (Table 4)supporting

confidence: 76%

“…A retrospective study found that the number of procedures increased from 47.5 to 88.9 per 100,000 Medicare beneficiaries between 2009 and 2015 [11] . A large study based on national registry data in the Netherlands showed more than twice the number of SAVRs were reported in 1995 compared with 2010 [10] . The authors concluded that this trend can be partly attributed to an increased prevalence of valvular heart disease sample.…”

Section: Discussionmentioning

confidence: 99%

“…Age plays a major role in bioprosthetic valve selection for patients with and without comorbidities, specifically in coronary artery disease patients and partly to an increased proportion of diseased patients that are diagnosed. Because the mean age of the patients has risen, both are likely to have played an important role [3,10] .…”

Section: Factors Associated With Ihm (Table 4)mentioning

confidence: 99%

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National Trends in Utilization and In-Hospital Outcomes of Surgical Aortic Valve Replacements in Spain, 2001-2015

Jiménez‐García¹,

Pérez-Farinós²,

Miguel-Díez³

et al. 2020

Braz J Cardiovasc Surg

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Objective: The aims of this study were to examine the incidence and in-hospital outcomes of surgical aortic valve replacement (SAVR) and to identify factors associated with in-hospital mortality (IHM) among patients according to the type of implanted valve used in SAVR. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001-2015. We included patients who had SAVR listed as a procedure in their discharge report. Results: We identified 86,578 patients who underwent SAVR (52.78% mechanical and 47.22% bioprosthetic). Incidence of SAVR coding increased significantly from 11.95 cases per 100,000 inhabitants in 2001 to 17.92 in 2015 (P<0.001). Age and comorbidities increased over time (P<0.001). There was a significant increase in the frequency of concomitant coronary artery bypass grafting (CABG) and in the use of pacemaker implantation. The use of mechanical SAVR decreased and the use of bioprosthetic valves increased over time. IHM decreased over time (from 8.13% in 2001-05 to 5.39% in 2011-15). Patients who underwent mechanical SAVR had higher IHM than those who underwent bioprosthetic SAVR (7.44% vs. 6%; P<0.05). Higher IHM rates were associated with advanced age, female sex, comorbidities, concomitant CABG, and the use of mechanical SAVR (OR 1.67; 95% CI 1.57-1.77). Conclusion: The number of SAVRs performed in Spain has increased since 2001. The use of mechanical SAVR has decreased and the use of bioprosthetic valves has increased over time. IHM has decreased over time for both types of valves and despite a concomitant increase in age and comorbidities of patients during the same period.

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Section: Discussionsupporting

confidence: 91%

Section: Factors Associated With Ihm (Table 4)supporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Factors Associated With Ihm (Table 4)mentioning

confidence: 99%

See 2 more Smart Citations

National Trends in Utilization and In-Hospital Outcomes of Surgical Aortic Valve Replacements in Spain, 2001-2015

Jiménez‐García¹,

Pérez-Farinós²,

Miguel-Díez³

et al. 2020

Braz J Cardiovasc Surg

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“…Fourth, the rates of reoperation might be influenced by differences in reporting. Reoperations have previously been reported as a repeat attempt of the initial surgery 31 while we registered all reoperations, including bleeding and deep sternal infections. Finally, as the study was a descriptive, hypothesis‐generating study, the risk of type 2 errors is increased.…”

Section: Discussionmentioning

confidence: 99%

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

et al. 2020

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Objectives The objectives of the study were to describe the causes of readmission from discharge to 30 days and from day 31 to 180 after discharge and to investigate the characteristics associated with overall and cause‐specific readmissions after open‐heart valve surgery. Methods A single‐center, retrospective cohort of 980 patients undergoing open‐heart valve surgery from 2013 to 2016. Time to the first readmission was analyzed using univariable and multivariable Cox proportional hazard models. Results are reported as hazard ratios (HR) with 95% confidence intervals (CI). Results In total, 366 patients (37%) experienced unplanned cardiac readmission within 180 days after discharge. Within 30 days after discharge, the most frequent causes of readmission were pericardial/pleural effusions (n = 87), infections (n = 50), and atrial fibrillation/flutter (n = 45). Accordingly, infections (n = 32) were the most common cause from day 31 to 180. No powerful predictors of overall cardiac readmission were identified, but several characteristics were associated with cause‐specific readmissions: age ≤65 years (HR: 1.85; CI: 1.18‐2.88), male gender (HR: 1.85; CI: 1.11‐3.09), high alcohol intake (HR: 1.99; CI: 1.22‐3.24) and mitral valve procedures (HR: 1.86; CI: 1.11‐3.10) were associated with readmissions due to effusions. Ischemic heart disease with a prior percutaneous coronary intervention (HR: 2.94; CI: 1.53‐5.63), mitral valve procedures (HR: 2.10; CI: 1.23‐3.59), and postoperative atrial fibrillation/flutter (HR: 1.71; CI: 1.03‐2.85) were associated with atrial fibrillation/flutter readmissions. Conclusion Predicting overall readmissions after open‐heart valve surgery is difficult as causes of readmissions vary and different causes are associated with different characteristics. Future studies should target reducing cause‐specific readmissions.

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Remote ischaemic preconditioning for coronary artery bypass grafting (with or without valve surgery)

Benstoem

Stoppe

Liakopoulos

et al. 2017

Cochrane Database of Systematic Reviews

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We found no evidence that RIPC has a treatment effect on clinical outcomes (measured as a composite endpoint including all-cause mortality, non-fatal myocardial infarction or any new stroke, or both, assessed at 30 days after surgery). There is moderate-quality evidence that RIPC has no treatment effect on the rate of the composite endpoint including all-cause mortality, non-fatal myocardial infarction or any new stroke assessed at 30 days after surgery, or both. We found moderate-quality evidence that RIPC reduces the cTnT release measured at 72 hours after surgery and expressed as AUC (72 hours). There is moderate-quality evidence that RIPC reduces the amount of cTnI release measured at 48 hours, and measured 72 hours after surgery. Adequately-designed studies, especially focusing on influencing factors, e.g. with regard to anaesthetic management, are encouraged and should systematically analyse the commonly used medications of people with cardiovascular diseases.

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Trends and outcomes of valve surgery: 16-year results of Netherlands Cardiac Surgery National Database†

Cited by 60 publications

References 17 publications

National Trends in Utilization and In-Hospital Outcomes of Surgical Aortic Valve Replacements in Spain, 2001-2015

National Trends in Utilization and In-Hospital Outcomes of Surgical Aortic Valve Replacements in Spain, 2001-2015

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

Remote ischaemic preconditioning for coronary artery bypass grafting (with or without valve surgery)

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