J.Jpn. Surg. Soc.. 113(3): 278-282, 2012

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Feature topic

COMPARISON OF JAPANESE VALVE SURGERY RESULTS WITH THOSE IN EUROPE AND THE USA

It was thought that the performance of heart valve surgery in Japan would decline with the decrease in cases of rheumatic heart disease, but there has been a clear increase over the last 10 years. Aortic valve stenosis related to aging and an increase in degenerative mitral valve disease are important factors in this increase. The results of surgical treatment based on annual reports from the Japanese Association for Thoracic Surgery, Japanese Society for Cardiovascular Surgery database, and Society of Thoracic Surgeons database in the USA were compared. The outcome of aortic valve replacement was stable and excellent, with operative mortality rates of 2.7% to 3.7% in all areas (Japan, Europe, and the USA) and no differences among the areas. From 2004 to 2005, the use of bioprosthetic valves exceeded that of mechanical valves in all three areas. While the operative mortality rate remains at around 4.7-6.0% for mitral valve replacement, the results are similar in all areas. The operative mortality rate for mitral valvuloplasty has been in the range of 1.2-1.8% over the past 10 years, and the number of valvuloplasty cases has exceeded replacement cases since 2005. There are no differences among the areas, with excellent results reported. In conclusion, although outcomes in Japan are not superior to those in Europe and the USA, results at the same level were clearly achieved in the field of valve surgery.

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