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. 2021 Jan 26:62:395-401.
doi: 10.1016/j.amsu.2021.01.077. eCollection 2021 Feb.

Predictors of short-term mortality after rheumatic heart valve surgery: A single-center retrospective study

Khalid S Ibrahim  1 , Khalid A Kheirallah  2 , Fadia A Mayyas  3 , Nizar R Alwaqfi  1 , Murtada H Alawami  4 , Qusai M Aljarrah  5
Affiliations

Predictors of short-term mortality after rheumatic heart valve surgery: A single-center retrospective study

Khalid S Ibrahim et al. Ann Med Surg (Lond). .

Abstract

Background: Valve replacement surgeries holds risks of morbidity and mortality.

Materials and methods: The study cohort included 346 patients who underwent different types of valve surgery, excluding redo and Bentall operations. All operations were performed through a median sternotomy using cardiopulmonary bypass.

Results: Mean patient age was 51.6 ± 16.1 years, and 51% were male. Approximately 21% had diabetes, and 44.6% were hypertensive. Aortic valve replacement (AVR) was performed in 125 patients (37%), mitral valve replacement (MVR) in 95 (28%), combined AVR and MVR in 42 (13%), AVR plus coronary artery bypass grafting (CABG) in 19 (6%), and MVR plus CABG in 32 (10%). Operative mortality was 5.8% (n = 20). In the bivariate-level analysis, older age, operation type, hypertension, emergency surgery, use of a biological valve in the aortic or mitral position, pump time greater than 120 min, and aortic clamp time greater than 60 min were significant predictors of 30-day mortality. Use of medications stratified by duration (less than or more than a month) was also shown to be a predictor of mortality. Use of angiotensin-converting enzyme inhibitors, digoxin, beta-blockers, statins, and loop diuretics was associated with mortality. Older age, emergency/salvage surgery, use of beta-blockers for less than 1 month preoperatively, and use of a biological valve in the aortic position were significant and independent predictors of 30-day mortality.

Conclusion: Age, emergency valve surgery, use of a biological valve, use of beta-blockers for less than 1 month before surgery, type of surgery, EF<35%, pump time, and cross clamp time were all found to be independent predictors of mortality in patients undergoing valve surgery. Further prospective multicenter studies may be needed to provide a comprehensive assessment of mortality in patients undergoing valve surgery in Jordan.

Keywords: Emergency surgery; Mortality; Predictors; Valve surgery.

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Conflict of interest statement

NO CONFLICT OF INTEREST OF ANY TYPE FOR ANY OF THE AUTHORS.

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