Isolated aortic valve replacement in Spain: national trends in risks, valve types, and mortality from 1998 to 2017

• Published in: Revista española de cardiología (English ed.) 2021-08, Vol.74 (8), p.700-707
• Main Authors: Carnero-Alcázar, Manuel, Maroto-Castellanos, Luis Carlos, Hernández-Vaquero, Daniel, López-Menéndez, José, Hornero-Sos, Fernando, Silva-Guisasola, Jacobo, Cobiella-Carnicer, Javier, Pérez-Camargo, Daniel, Álvarez-de Arcaya, María Arantzatzu, Campelos-Fernández, Paula, Elvira-Martínez, Carlos
• Format: Article
• Language: English
• Subjects: Aortic valve replacement; Cirugía; Mortalidad; Mortality; Surgery; Sustitución valvular aórtica
• ISSN: 1885-5857; 1885-5857
• DOI: 10.1016/j.rec.2020.06.008

To help to illustrate the trends in isolated surgical aortic valve replacement (SAVR) in Spain, we performed a national-level analysis to investigate the changes from 1998 to 2017 in a) SAVR volume, b) patients’ risk profiles, c) in-hospital mortality, and d) types of aortic valve prostheses. We included all episodes of patients undergoing isolated SAVR from January 1998 to December 2017 recorded in the Minimum Basic Data Set (Ministry of Health, Consumer Affairs, and Social Welfare, Spain). The study duration was divided into four 5-year periods. We analyzed the trends in SAVR volume, comorbidity prevalence, and in-hospital mortality. Through multivariate logistic regression, we identified factors associated with mortality and type of prosthesis. The risk-adjusted mortality rate was compared over the study period. In total, 73 668 patients underwent an isolated SAVR from 1998 to 2017. The annual volume of procedures increased from 16 363 between 1998 and 2002 to 22 685 between 2013 and 2017. The prevalence of all investigated comorbidities increased, except for history of previous myocardial infarction and unplanned admission. The Charlson comorbidity index worsened from 1998-2002 (2.3; SD, 1.4) to 2013-2017 (3.6; SD, 1.7) (P