Key result
Age (OR 1.42), preoperative NYHA class (OR 1.35), pulmonary artery pressure (OR 1.28), and creatinine (OR 1.50) were independent risk factors for 30-day adverse outcomes after mitral stenosis surgery.
Why the study?
Limited contemporary data specifically examine predictors of early postoperative outcomes in patients undergoing surgery for mitral stenosis.
What are the predictors of early adverse outcomes, and does valve repair improve outcomes compared to valve replacement in patients undergoing surgery for mitral stenosis?
Cohort (n=106)
What are the predictors of early adverse outcomes, and does valve repair improve outcomes compared to valve replacement in patients undergoing surgery for mitral stenosis?
Age, NYHA class, pulmonary artery pressure, and creatinine are independent predictors of early adverse outcomes after mitral stenosis surgery, and valve repair is associated with better outcomes than replacement.
May inform risk stratification in mitral stenosis surgery; hypothesis-generating pending prospective validation.
Background Mitral stenosis (MS) remains a significant global health concern, particularly in developing countries where rheumatic heart disease is prevalent. Despite advances in cardiac surgery, the management of MS presents ongoing challenges. Understanding the factors that influence early postoperative outcomes is crucial for risk stratification, preoperative optimization, and patient counseling. However, limited contemporary data specifically examines predictors of early outcomes in patients undergoing surgery for MS. Methods This retrospective analysis included 106 patients who underwent mitral valve surgery for MS between January 2020 and December 2023. Patients were divided into two groups based on 30-day outcomes: adverse outcome group (n=26) and favorable outcome group (n=80). Preoperative variables, intraoperative factors, and postoperative outcomes were collected. Multivariate logistic regression analysis identified independent risk factors for adverse outcomes. Additional analysis compared outcomes between valve repair (n=66) and valve replacement (n=40) groups. Results The incidence of adverse outcomes within 30 days was 18.5%. Multivariate analysis identified several independent risk factors: age (OR 1.42, 95% CI 1.12-1.73), preoperative NYHA classification (OR 1.35, 95% CI 1.06-1.64), pulmonary artery pressure (OR 1.28, 95% CI 1.05-1.52), and preoperative creatinine (OR 1.50, 95% CI 1.10-2.05). The adverse outcome group experienced significantly longer ICU stays (6.2±2.5 vs 3.8±1.2 days), extended mechanical ventilation (52±20 vs 30±10 hours), and higher complication rates including infection, arrhythmia, and delirium. The valve repair group demonstrated significantly better outcomes than the replacement group, including higher long-term survival (85.0±5.2% vs 75.0±6.3%), better cardiac function recovery, improved quality of life, and lower complication rates. Conclusion Early postoperative outcomes after mitral stenosis surgery are influenced by multiple factors, with patient-related variables having greater impact than surgical technique factors. Valve repair is associated with more favorable outcomes compared to valve replacement across multiple parameters.
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Heyi et al. (2025) conducted a cohort in Mitral stenosis (n=106). Preoperative risk factors (age, NYHA class, pulmonary artery pressure, creatinine) was evaluated on Adverse outcomes within 30 days. Age (OR 1.42), preoperative NYHA class (OR 1.35), pulmonary artery pressure (OR 1.28), and creatinine (OR 1.50) were independent risk factors for 30-day adverse outcomes after mitral stenosis surgery.
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