Trends of aortic valve-preserving surgery in japan: an updated five-year nationwide survey.

IF 1.3 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

General Thoracic and Cardiovascular Surgery Pub Date : 2025-06-15 DOI:10.1007/s11748-025-02170-x

Satoshi Arimura, Takashi Kunihara, Yutaka Okita, Shuichiro Takanashi, Tatsuhiko Komiya, Hitoshi Yaku, Hitoshi Okabayashi, Hirofumi Takemura, Hirokuni Arai, Masaru Sawazaki, Yoshiro Matsui, Norihiko Shiiya

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引用次数: 0

Abstract

Objective: We evaluated trends and outcomes of aortic valve-preserving surgery (AVPS) in Japan, particularly with regard to aortic regurgitation (AR), in comparison with data from 2014.

Methods: We conducted a nationwide survey across 244 hospitals in Japan, focusing on aortic valve and aortic root surgeries performed in 2019. The breakdown of procedures, including isolated aortic valvuloplasty (AVP) and valve-sparing root replacement (VSRR), in AR patients was examined, and compared with the results from 2014.

Results: In 2019, the isolated AVP rate for AR was 5.5%, down from 7.5% in 2014. The VSRR rate among aortic root surgeries remained (33.1%). Within VSRR procedures, aortic valve reimplantation (reimplantation) accounted for 62.7% of cases, aortic root remodeling (remodeling) for 32.0%, and other root replacement techniques for 5.3%. AVPS was performed in 102 hospitals, with 10 institutions accounting for 42.2% of all cases. One-year reoperation rates for AVP, reimplantation, remodeling, and other root replacement were 8.0%, 1.8%, 6.0%, and 14.3%, respectively. Short-term (up to 4 years) aortic valve-related reoperation rates for AVP, reimplantation, and remodeling were 9.7%, 6.1%, and 9.5%, respectively. Use of a pericardial patch emerged as an independent risk factor for reoperation following AVPS (P = 0.022; odds ratio 3.382; 95% confidence interval 1.195-9.570).

Conclusions: The rate of AVP performed for AR in Japan decreased significantly from 2014 to 2019, while the rate of VSRR for root procedures remained stable. Use of a pericardial patch was identified as an independent risk factor for aortic valve-related reoperation following initial repair.

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日本主动脉瓣保留手术的趋势：一项最新的五年全国调查。

目的：我们评估了日本主动脉瓣保留手术（AVPS）的趋势和结果，特别是主动脉瓣反流（AR），并与2014年的数据进行了比较。方法：我们对日本244家医院进行了全国范围的调查，重点是2019年进行的主动脉瓣和主动脉根部手术。研究了AR患者的手术失败情况，包括孤立主动脉瓣成形术（AVP）和保留瓣膜的根置换术（VSRR），并与2014年的结果进行了比较。结果：2019年，AR的孤立AVP率为5.5%，低于2014年的7.5%。主动脉根部手术的VSRR率保持不变（33.1%）。在VSRR手术中，主动脉瓣再植（replantation）占62.7%，主动脉根重塑（remodeling）占32.0%，其他根置换技术占5.3%。102家医院实施了AVPS，其中10家机构占42.2%。AVP再手术率为8.0%，再植率为1.8%，重塑率为6.0%，其他根置换率为14.3%。AVP的短期（最多4年）主动脉瓣相关再手术率、再植入术率和重塑率分别为9.7%、6.1%和9.5%。心包贴片的使用是AVPS后再手术的独立危险因素(P = 0.022；优势比3.382；95%置信区间1.195-9.570)。结论：2014 - 2019年，日本AR的AVP率显著下降，而根管手术的VSRR率保持稳定。心包贴片的使用被认为是主动脉瓣初次修复后再次手术的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine

CiteScore

2.70

自引率

8.30%

发文量

142

期刊介绍： The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.