The valve disease surveillance system established by Santé publique France makes it possible to study the epidemiological trends of these conditions.

Increasing Number of Patients Hospitalized for Valvular Heart Disease

In 2016, 38,875 patients were hospitalized for the treatment of valvular heart disease in France: 89.0% of them were hospitalized for non-rheumatic valvular heart disease (average age: 74 years – 42% women); 5.2% for rheumatic valvular heart disease (mean age: 67 years – 63% women), 2.6% for congenital valvular heart disease (mean age: 29 years – 40% women), and 3.2% for valvular heart disease of unspecified origin.
The standardized incidence rate of patients hospitalized for non-rheumatic valvular heart disease has been rising for several years and stood at 52 per 100,000 person-years in 2016. This rate was much lower for patients hospitalized for rheumatic valvular heart disease, at 3 patients per 100,000 person-years in 2016, with a reverse trend, showing a decline.

Aortic stenosis is the most common valvular heart disease in France, ahead of mitral regurgitation

In Europe, the most common type of valvular heart disease is aortic stenosis. The primary cause of this condition is degenerative. In France, the incidence rate of patients hospitalized for the management of aortic stenosis is on the rise, particularly among those over 75 years of age. This can be explained by several factors, including the aging population, but also by the development of transcatheter aortic valve implantation (TAVI). This recent technique is less invasive than open-heart surgery performed under general anesthesia, and thus allows for the treatment of certain patients with contraindications to conventional valve replacement surgery.

Stable Mortality Rates for Non-Rheumatic Valvular Heart Disease

In France, in 2014, 11,179 people died with valvular heart disease listed as the primary or contributing cause on their death certificates. The most common types of valvular heart disease were non-rheumatic in origin (75.9%). Rheumatic valvular heart disease accounted for 21.8% of deaths, and congenital valvular heart disease accounted for 39 deaths (0.3%).
The standardized mortality rate for non-rheumatic valvular heart disease was 12 per 100,000 person-years in 2014. The mortality rate for non-rheumatic valvular heart disease was generally stable between 2000 and 2014, but it decreased among younger patients and increased among older patients, reflecting a higher age at death.
The age-standardized mortality rate for rheumatic valvular heart disease decreased between 2000 and 2014, when it stood at 3.5 per 100,000 person-years.

Significant regional disparities

Analysis of standardized rates by department revealed disparities in mortality related to valvular heart disease across France (aggregated data from 2012–2014).
Specifically, the highest standardized mortality rates for non-rheumatic valvular heart disease were found in Manche (19.0/100,000 population), Pas-de-Calais (18.9/100,000 population), Finistère (18.3/100,000 population), Morbihan (17.9/100,000 population), Bas-Rhin (17.7/100,000 population), and Haute-Saône (16.8/100,000 population). These rates were lowest in southeastern France (Alpes-de-Haute-Provence (6.7 per 100,000 population)) and the overseas departments [French Guiana (5.5); Martinique (3.6); Guadeloupe (3.2)].
Regarding standardized mortality rates related to rheumatic valvular heart disease, the highest rates were found in the Loire (7.8 per 100,000 population), the Belfort region (7.2 per 100,000 population), Haute-Loire (6.5 per 100,000 population), and Haute-Saône (5.9 per 100,000 population).