OBJECTIVES: To describe the trends in the volume, type of aortic valve protheses, and in-hospital resource consumption for patients undergoing isolated surgical aortic valve replacement (SAVR) for aortic regurgitation (AR) in Spain.

METHODS: The analysis included all episodes of patients undergoing isolated SAVR from January 2016 to December 2019, recorded in the Spanish Ministry of Health public database (RAE-CMBD) and coded under the ICD-10 codes I35.1 and I06.1. Trends in SAVR volumes, patient baseline characteristics, risk profile, length-of-stay, and related DRG costs (2019€) were examined.

RESULTS: A total of 2,916 isolated SAVR procedures for AR were identified during the 4-year period analysed, among which 96% were non-rheumatic AR. Overall, a higher proportion of SAVR procedures were performed with tissue valves vs mechanical ones (57%, n= 1,676 vs 43%, n=1,240) (p<0.001). While the total number of SAVRs increased from 658 in 2016 to 769 in 2019 (p<0.001), the proportion of valves implemented remained stable. There was a higher proportion of females receiving tissue valves (31%) vs mechanical valves (23%) (p<0.001). Patients that received tissue valves were older (mean, SD: 70.59 years, 10.16 vs 58.57, 12.78 years; p<0.001) but their mean age decreased over time from 71.6 years in 2016 to 69.39 in 2019 (p=0.011). The Charlson comorbidity index was also higher for patients on tissue valves (mean, SD: 3.83, 1.72 vs 2.52, 1.72; p<0.001). SAVR patients stayed in-hospital for a mean of 15.97 days/year (SD 7.29), of which 3.59 days (SD 7.30) were in the intensive care unit The estimated direct cost per patient/year was 26,942.16 (SD 9,739.82) and accumulated to a spending of 78.54M€ over 4-years (mean annual cost of 19.64M€).

CONCLUSIONS: This study reported an increasing trend in the volume of SAVR procedures for AR over the past years and if maintained may further increase burden of Structural Heart Diseases in Spain.