THE EPIDEMIOLOGY OF PROSTHETIC HEART-VALVES IN THE UNITED-STATES

The Centers for Devices and Radiological Health of the Food and Drug A dministration, in collaboration with the National Center for Health St atistics, conducted the Medical Device Implant Supplement to the 1988 National Health Interview Survey, generating the 1st available populat ion-based estimates of the use of prosthetic heart valves in the Unite d States. The 1988 National Health Interview Survey was a massive, nat ionally representative cross-sectional survey that encompassed 47,485 households and 122,310 individuals. Data from the Medical Device Impla nt Supplement indicate that an estimated 253,283 persons with 279,175 heart valves were present in the civilian, non-institutionalized US po pulation (population prevalence of 1.1/1,000, 95% Cl 0.8-1.3). Prevale nce of valve prostheses ranged from 0.2 per 1,000 in those age 44 and under to 5.3 per 1,000 in those 75 years of age and older. Age-adjuste d prevalence of valve prostheses did not differ significantly accordin g to sex, race, region of residence, education, or income of recipient s. Two thirds of aortic valve recipients identified by the survey were male, compared with only one third of mitral valve recipients. Approx imately two thirds of both aortic and mitral valve implants were repor ted as mechanical. Reported use of anticoagulative agents was signific antly more common in recipients of mechanical than of bioprosthetic va lves. The single most common reported reason for prosthetic valve impl antation was rheumatic heart disease. These data provide useful epidem iologic and public health planning information on prosthetic heart val ve use.