The impact of heart valve replacement surgery start time on patients with rheumatic heart disease

Objectives Rheumatic heart disease (RHD) remains prevalent in developing regions, often leading to significant valvular damage. This study aimed to assess whether the start time of heart valve replacement surgery influences short-term clinical outcomes in patients with rheumatic heart disease. Methods This retrospective analysis included 300 adult patients who underwent elective valve replacement surgery between January 2020 and January 2023. Patients were divided into two groups based on surgery start time: morning (AM group: 7 a.m.–1 p.m.) and afternoon (PM group: after 1 p.m.). Propensity score matching and logistic regression were used to compare mortality, complications, intensive care unit (ICU) stay, and hospitalization. Results After matching, 283 patients were analyzed (AM: 137, PM: 146). No significant differences were found between groups in postoperative mortality (odds ratios = 0.31, P = 0.17), bleeding reoperation ( P = 0.70), blood product usage ( P > 0.60), ICU stay ( P = 0.12), ventilation time ( P = 0.37), or hospitalization cost ( P = 0.40). However, total hospitalization time was longer in the AM group ( P = 0.01), influenced by factors such as cardiac function, liver insufficiency, and surgical complexity. Conclusions Surgery start time did not significantly affect short-term outcomes in patients with rheumatic heart disease undergoing valve replacement. Differences in hospital stay duration may be attributable to patient-specific factors and surgical complexity.