Satoshi Arimura1, Masahiro Seki1, Kenichi Sasaki1, Hideaki Takai1, Minoru Matsuhama1, Takashi Kunihara2, Yutaka Okita3, Shuichiro Takanashi4, Tatsuhiko Komiya5, Hitoshi Yaku6, Hitoshi Okabayashi7, Hirofumi Takemura8, Hirokuni Arai9, Masaru Sawazaki10, Yoshiro Matsui11, Norihiko Shiiya12. 1. Department of Cardiovascular Surgery, The Cardiovascular Institute, Tokyo, Japan. 2. Department of Cardiovascular Surgery, The Cardiovascular Institute, Tokyo, Japan. kunihara@cvi.or.jp. 3. Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan. 4. Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. 5. Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Okayama, Japan. 6. Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. 7. Department of Cardiovascular Surgery, Iwate Medical University, Morioka, Iwate, Japan. 8. Department of Thoracic, Cardiovascular and General Surgery, Kanazawa University, Kanazawa, Ishikawa, Japan. 9. Department of Cardiovascular Surgery, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan. 10. Department of Cardiovascular Surgery, Heart Valve Center, Komaki City Hospital, Komaki, Aichi, Japan. 11. Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. 12. First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Abstract
OBJECTIVE: Although aortic valve-sparing operations are performed throughout Japan, the indications, specific repair techniques, and outcomes have not been reported in full. Thus, we conducted the first nationwide survey of aortic valve-sparing surgery. METHODS: We mailed a questionnaire to 508 institutions across Japan to obtain information on elective aortic valve and aortic root surgeries performed in 2014. Included in the mailing was a secondary questionnaire that sought further information from institutions reporting aortic valve-sparing surgeries. RESULTS: Two hundred and fifty (49%) institutions responded and reported a total of 7859 aortic valve operations and 771 aortic root operations. Aortic valve operations performed strictly for aortic regurgitation totaled 2080, 156 (8%) of which were aortic valve repairs. Of the 699 aortic root surgeries performed for aortic regurgitation, 236 (34%) were valve-sparing root replacement surgeries. The valve-sparing root replacement surgeries comprised aortic valve reimplantation (n = 173, 73%) and aortic root remodeling (n = 63, 27%). Five of 57 (9%) institutions were responsible for 42% (99/233) of the total aortic valve-sparing surgeries performed. Detailed information that was obtained for 233 patients who underwent aortic valve repair or valve-sparing root replacement showed 30-day mortality and reoperation for regurgitation after aortic valve repair (n = 97), aortic root remodeling (n = 37), and aortic valve reimplantation (n = 99) to be 1, 0, and 1% and 3, 3, and 1%, respectively. CONCLUSION: To date, aortic valve-sparing operations have been performed for limited patients at limited institution in Japan, but the early outcomes have been excellent.
OBJECTIVE: Although aortic valve-sparing operations are performed throughout Japan, the indications, specific repair techniques, and outcomes have not been reported in full. Thus, we conducted the first nationwide survey of aortic valve-sparing surgery. METHODS: We mailed a questionnaire to 508 institutions across Japan to obtain information on elective aortic valve and aortic root surgeries performed in 2014. Included in the mailing was a secondary questionnaire that sought further information from institutions reporting aortic valve-sparing surgeries. RESULTS: Two hundred and fifty (49%) institutions responded and reported a total of 7859 aortic valve operations and 771 aortic root operations. Aortic valve operations performed strictly for aortic regurgitation totaled 2080, 156 (8%) of which were aortic valve repairs. Of the 699 aortic root surgeries performed for aortic regurgitation, 236 (34%) were valve-sparing root replacement surgeries. The valve-sparing root replacement surgeries comprised aortic valve reimplantation (n = 173, 73%) and aortic root remodeling (n = 63, 27%). Five of 57 (9%) institutions were responsible for 42% (99/233) of the total aortic valve-sparing surgeries performed. Detailed information that was obtained for 233 patients who underwent aortic valve repair or valve-sparing root replacement showed 30-day mortality and reoperation for regurgitation after aortic valve repair (n = 97), aortic root remodeling (n = 37), and aortic valve reimplantation (n = 99) to be 1, 0, and 1% and 3, 3, and 1%, respectively. CONCLUSION: To date, aortic valve-sparing operations have been performed for limited patients at limited institution in Japan, but the early outcomes have been excellent.
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