Early Mortality Following Mitral Valve Surgery in Patients With Rheumatic Heart Disease and Severe Pulmonary Hypertension

Q: What are the key findings of this study?

Severe pulmonary hypertension did not significantly increase 3-month mortality compared to non-severe pulmonary hypertension following mitral valve surgery for rheumatic heart disease (12.3% vs 9.1%).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Rheumatic heart disease (n=134). Intervention: Mitral valve surgery with severe pulmonary hypertension (sPAP ≥60 mmHg) vs. Mitral valve surgery with non-severe pulmonary hypertension (sPAP <60 mmHg). Primary outcome: 3-month all-cause mortality (p=0.551).

Q: What does this research mean for the field?

Mitral valve surgery in patients with severe pulmonary hypertension resulted in a 3-month survival rate of 89.6%, with early mortality at 10.4%. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Naseem Alwsabi; Abudar A. M. Alganadi; Mahdi A. Kadry; Tarq null Noman; Salem Bashraheel; Sedqi Alkubati; Ismail Samer Alshameri; Feras Al Mghizel; Nada Alwsabi

doi:10.31083/hsf50002

January 14, 2026The Heart Surgery ForumOpen Access

Early Mortality Following Mitral Valve Surgery in Patients With Rheumatic Heart Disease and Severe Pulmonary Hypertension

View Full Paper

Ask AI

Bookmark

Share

Key result

Severe PH is not associated with higher 3-month mortality after rheumatic mitral valve surgery.

P=0.551
n=134

Why the study?

Prospective data on early postoperative outcomes, including 3-month mortality, following mitral valve surgery for rheumatic heart disease with pulmonary hypertension are limited in Yemen.

Does severe preoperative pulmonary hypertension increase early mortality in adult patients with rheumatic heart disease undergoing mitral valve surgery?

Key Points

To evaluate the association between preoperative pulmonary hypertension severity and 3-month outcomes following mitral valve surgery for rheumatic heart disease in Yemen.
Prospective observational study of 134 adult patients with rheumatic heart disease undergoing mitral valve surgery at the Cardiovascular and Kidney Transplantation Center in Taiz, Yemen, between January 2022 and August 2024.
Patients were stratified by preoperative systolic pulmonary artery pressure into Group I (<60 mmHg, n = 77) and Group II (≥60 mmHg, n = 57), with clinical follow-up conducted at 3 months postoperatively.
The 30-day mortality rate was 3.9% in Group I versus 3.5% in Group II (p = 0.907).
The overall 3-month all-cause mortality rate was 10.4%, with no significant difference between Group I and Group II (12.3% vs. 9.1%; p = 0.551) and an overall 3-month survival rate of 89.6%.
Early complication rates and hospital readmissions were comparable between the two groups.

Study Design

Type

Observational (n=134)

Multicenter

No

Structured PICO

Does severe preoperative pulmonary hypertension increase early mortality in adult patients with rheumatic heart disease undergoing mitral valve surgery?

P

Population

134 adult patients with rheumatic heart disease (RHD) undergoing mitral valve surgery, median age 38.5, 83 female, based in Yemen. Key inclusion: adult patients diagnosed with RHD undergoing mitral valve surgery. Key exclusion: isolated aortic valve disease, degenerative or ischemic mitral regurgitation, primary pulmonary hypertension, COPD, renal dysfunction (serum creatinine ≥2 mg/dL), or hepatic impairment (total serum bilirubin ≥3 mg/dL).

I

Intervention

Mitral valve surgery in patients with severe preoperative pulmonary hypertension (systolic pulmonary artery pressure ≥60 mmHg)

C

Comparator

Mitral valve surgery in patients with non-severe preoperative pulmonary hypertension (systolic pulmonary artery pressure <60 mmHg)

O

Outcome

30-day mortality (death from any cause within 30 days of surgery) and 3-month mortality (death from any cause within 90 days of surgery)hard clinical

Main Result

Absolute Event Rate: 12.3% vs 9.1%

p-value: p=0.551

Severe pulmonary hypertension does not significantly increase 30-day or 3-month mortality in patients with rheumatic heart disease undergoing mitral valve surgery in a resource-limited setting.

Limitations

Small sample size (n = 134) limiting statistical power and generalizability
Pulmonary hypertension was assessed using echocardiography-derived sPAP, subject to operator variability
Only short-term outcomes (30-day and 3-month) were evaluated
Single-center study conducted in a resource-limited setting
Relatively small sample size (n = 134)
PH was assessed using echocardiography-derived sPAP, which may be influenced by hemodynamic fluctuations and operator variability

Implication

Supports mitral valve surgery feasibility in severe PH; extends observational data but leaves confirmation to larger prospective studies.

Abstract

Background: Rheumatic heart disease (RHD) remains highly prevalent in Yemen, often presenting with advanced mitral valve lesions and pulmonary hypertension (PH). However, prospective data on early postoperative outcomes, including 3-month mortality, are limited. Therefore, this study aimed to evaluate the association between preoperative PH severity and 3-month outcomes following mitral valve surgery for RHD in Yemen. Methods: A prospective observational study was performed on 134 adult patients with RHD who were undergoing mitral valve surgery at the Cardiovascular and Kidney Transplantation Center, Taiz, Yemen (January 2022–August 2024). Patients were stratified according to preoperative systolic pulmonary artery pressure (sPAP) into Group I (<60 mmHg) and Group II (≥60 mmHg). All-cause 3-month mortality, readmissions, and major postoperative complications were recorded. Results: The 30-day mortality was low and did not differ significantly between groups (3.9% vs. 3.5%; p = 0.907). The overall 3-month all-cause mortality rate was 10.4%, with no significant difference in mortality within the two groups (12.3% vs. 9.1%; p = 0.551). The early complication rates and hospital readmissions were comparable between groups. Conclusions: Early mitral valve surgery before the development of severe PH and right ventricular dysfunction was shown to improve survival outcomes. Surgery is safe and feasible for RHD patients with severe PH, with low early mortality and an 89.6% 3-month survival rate.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Alwsabi et al. (2026) conducted an observational in Rheumatic heart disease (n=134). Mitral valve surgery with severe pulmonary hypertension (sPAP ≥60 mmHg) vs. Mitral valve surgery with non-severe pulmonary hypertension (sPAP <60 mmHg) was evaluated on 3-month all-cause mortality (p=0.551). Severe pulmonary hypertension did not significantly increase 3-month mortality compared to non-severe pulmonary hypertension following mitral valve surgery for rheumatic heart disease (12.3% vs 9.1%).

synapsesocial.com/papers/6980fd60c1c9540dea80f198 https://doi.org/10.31083/hsf50002

View Full Paper

Ask AI

Bookmark

Share

Early Mortality Following Mitral Valve Surgery in Patients With Rheumatic Heart Disease and Severe Pulmonary Hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Early Mortality Following Mitral Valve Surgery in Patients With Rheumatic Heart Disease and Severe Pulmonary Hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading