Use of valve surgery in Canada.

BACKGROUND: To date, although clinical databases have been used to report on single centre or regional valve surgery outcomes, neither clinical nor administrative data have been used to examine rates of valve surgery use across large geographical regions. The objective of the present study was to use administrative data to evaluate use of valve surgery over time and across Canada. METHODS: All cases of aortic valve replacement (AVR), mitral valve replacement (MVR), mitral valve repair (MV repair), combined AVR and coronary artery bypass grafting (CABG), and combined MVR/MV repair and CABG between fiscal years 1994/95 and 1999/2000 were identified using hospital discharge abstract data obtained from the Canadian Institute of Health Information. Age- and sex-adjusted rates of valve surgery were then calculated by province and by procedure type. RESULTS: Rates of valve surgery for all procedure types increased between fiscal years 1994/95 and 1999/2000 with the exception of MVR, which remained relatively constant. Significant variation in rates of valve surgery was found between male and female residents. Similar variation was also demonstrated across provinces by year and by procedure type. CONCLUSION: There was a trend toward increased use of valve surgery over time for most procedures. Variation in rates of valve surgery exists across provinces. These results provide a starting point from which to track future trends in use and outcomes for these major procedures.