A Profile of Valve Replacement Surgery in the UK (1986-1997):
A Study From the UK Heart Valve Registry
Maria-Benedicta Edwards MPhil, Kenneth M. Taylor FRCS

Approximately 150,000 heart valves are implanted annually worldwide. We present trend analyses in valve replacement (VR) surgery in the UK since 1986 based on data from the UK Heart Valve Registry (UKHVR), a computerized database collecting prospective data on VR surgery in all UK cardiac units. Between January 1st 1986 and December 31st 1997, a total of 63,649 valves were implanted in first-time VR operations. Mean age at operation has risen from 59 to 65 years and the percentage of patients aged >70 years has increased from 12% to 36%. The incidence of double VR and mitral VR surgery has fallen. Mechanical valves are preferred, and specifically bileaflet valves. Follow up was 96.1% complete, and comprised a total 342,993 patient-years. Thirty-day mortality rates fell from 6.9% in 1986 to 3.8% in 1995. Actuarial survival at 10 years was 61.8%. In conclusion, UKHVR data provide comprehensive trend analyses. Changing patterns in patient demographics, valve preference and heart valve disease are evident within the UK.