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
Korean Journal of Thoracic and Cardiovascular Surgery 2021³â 54±Ç 5È£ p.369 ~ p.376
¿ìÇõ»ó(Woo Hyeok-Sang) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
Ȳȣ¿µ(Hwang Ho-Young) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
±èÈ£Áø(Kim Ho-Jin) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
±èÁعü(Kim Joon-Bum) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
ÀÌ»è(Lee Sak) - Severance Cardiovascular Hospital Department of Thoracic and Cardiovascular Surgery
ÀÓû(Lim Cheong) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Thoracic and Cardiovascular Surgery
À庴ö(Chang Byung-Cheul) - CHA University CHA Bundang Medical Center Department of Thoracic and Cardiovascular Surgery
À̳ª·¡(Lee Na-Rae) - National Evidence-Based Healthcare Collaborating Agency
¼À¯½Å(Suh You-Shin) - National Evidence-Based Healthcare Collaborating Agency
ÃÖÀç¿õ(Choi Jae-Woong) - Seoul National University Hospital Department of Thoracic and Cardiovascular Surgery
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¡¾28.78 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.
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Aortic valve surgery, Korea, Rapid deployment valve, Sutureless valve, Trends
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