Key result
Emergency valve surgery is linked to ~7.1-fold higher 30-day mortality compared to elective surgery.
Why the study?
Predictors of short-term mortality after heart valve surgery remain incompletely defined, motivating investigation at a single center.
Observational (n=346)
No
Odds Ratio: 7.12
Absolute Event Rate: 18.8% vs 4.9%
p-value: p=0.034
Identifies local predictors of short-term mortality after valve surgery; leaves open external validation in prospective cohorts.
Objective To investigate predictors of short-term mortality after valve surgery at our center. 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 minutes, and aortic clamp time greater than 60 minutes were significant predictors of 30-day 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 Older age, emergency valve surgery, use of a biological valve, and use of beta-blockers for less than 1 month before surgery were all found to be independent predictors of mortality in patients undergoing valve surgery.
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Ibrahim et al. (2020) conducted an observational in Valvular heart disease (n=346). Emergency valve surgery vs. Elective valve surgery was evaluated on 30-day all-cause mortality (OR 7.12, p=0.034). Emergency valve surgery independently predicted increased 30-day mortality compared to elective surgery (OR 7.12, p=0.034), alongside older age, biologic valve use, and short-term preoperative beta-blocker use.
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