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, Edgar J Daeter Department of Cardiothoracic Surgery, St Antonius Hospital , Nieuwegein, Netherlands Search for other works by this author on: Oxford Academic Hector W L de Beaufort Department of Cardiothoracic Surgery, St Antonius Hospital , Nieuwegein, Netherlands Corresponding author. Department of Cardiothoracic Surgery, St Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands. Tel: +31-088-320-11-70; e-mail: h.de.beaufort@antoniusziekenhuis.nl (H.W.L. de Beaufort). Search for other works by this author on: Oxford Academic Maaike M Roefs Netherlands Heart Registration , Utrecht, Netherlands Search for other works by this author on: Oxford Academic Wim Jan P van Boven Department of Cardiothoracic Surgery, Amsterdam University Medical Center , Amsterdam, Netherlands Search for other works by this author on: Oxford Academic Dennis van Veghel Netherlands Heart Registration , Utrecht, Netherlands Search for other works by this author on: Oxford Academic Niels P van der Kaaij Department of Cardiothoracic Surgery, University Medical Center Utrecht , Utrecht, Netherlands Search for other works by this author on: Oxford Academic Cardiothoracic Surgery Registration Committee of the Netherlands Heart Registration Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0003-1658-9692 European Journal of Cardio-Thoracic Surgery, Volume 65, Issue 5, May 2024, ezae177, https://doi.org/10.1093/ejcts/ezae177
Published:
10 May 2024
Article history
Received:
26 June 2023
Revision received:
26 March 2024
Published:
10 May 2024
Corrected and typeset:
16 May 2024
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Edgar J Daeter, Hector W L de Beaufort, Maaike M Roefs, Wim Jan P van Boven, Dennis van Veghel, Niels P van der Kaaij, Cardiothoracic Surgery Registration Committee of the Netherlands Heart Registration , First-time surgical aortic valve replacement: nationwide trends and outcomes from The Netherlands Heart Registration, European Journal of Cardio-Thoracic Surgery, Volume 65, Issue 5, May 2024, ezae177, https://doi.org/10.1093/ejcts/ezae177
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Abstract
OBJECTIVES
The aim of this study was to describe trends and outcomes for patients undergoing surgical aortic valve replacement (SAVR) in the Netherlands.
METHODS
The Netherlands Heart Registration database was used to report the number and outcomes of isolated, primary SAVR procedures performed from 2007 to 2018 in adult patients.
RESULTS
A total of 17142 procedures were included, of which 77.9% were performed using a biological prosthesis and 21.0% with a mechanical prosthesis. Median logistic EuroSCORE I decreased from 4.6 [interquartile range (IQR) 2.4–7.7] to 4.0 (IQR 2.6–6.0). The 120-day mortality decreased from 3.3% in 2007 to 0.7% in 2018. The median duration of follow-up was 76 months (IQR 53–111). Ten-year survival, when adjusted for age, EuroSCORE I and body surface area, was 72.4%, and adjusted 10-year freedom from reinvervention was 98.1%. Additional analysis for patients under the age of 60 showed no difference between patients treated with a biological or mechanical prosthesis in adjusted 10-year survival, 89.7% vs 91.9±%, respectively (P = 0.25), but a significant difference in adjusted 10-year freedom from reintervention, 90.0±% vs 95.9%, respectively (P < 0.01).
CONCLUSIONS
Between 2007 and 2018, age and risk profile of patients undergoing SAVR decreased, especially for patients treated with a biological prosthesis. The 120-day mortality decreased over time. Patients undergoing SAVR nowadays have a risk of 120-day mortality of <1% and 10-year freedom from valve-related reintervention of >95%.
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Aortic valve replacement, Registry, Long-term outcomes, Netherlands Heart Registration
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
Topic:
- aortic valve replacement
- body surface area
- follow-up
- netherlands
- surgical procedures, operative
- heart
- mortality
- prostheses
- european system for cardiac operative risk evaluation
Subject
Valve Disorders (Acquired Cardiac) Clinical Epidemiology
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