A retrospective analysis shows mortality rates and risk factors after heart valve surgery

A retrospective analysis shows mortality rates and risk factors after heart valve surgery

Background and goals

Mechanical valve replacement is a primary treatment for rheumatic heart disease, but prosthesis-related side effects remain underreported in India. The aim of this study was to examine the in-hospital mortality rate in patients who had undergone heart valve replacement surgery in the past five years.

Methods

A retrospective analysis of 221 patients with rheumatic heart disease (2019-2023) who underwent aortic valve replacement (AVR), mitral valve replacement (MVR), or double valve replacement (DVR) was performed. Comorbidities (hypertension, type 2 diabetes mellitus) and valve origin (made in India vs. abroad) were also assessed. Data were analyzed using SPSS (v25.0).P<0.05 is considered statistically significant.

Results

262 valves were implanted in 221 patients (54 AVR, 126 MVR, 41 DVR). Overall in-hospital mortality was 7.24% (16/221), with rates of 5.55% (AVR), 7.14% (MVR), and 9.75% (DVR). No gender differences were observed (P> 0.05). The five-year actuarial survival rate was 92.8 ± 4.8%, with no differences between groups (P> 0.05). Mortality was higher in patients over 50 years of age (13/16 deaths) and in women (10/16 deaths), although these differences were not statistically significant. Hypertension was more common in women and type 2 diabetes mellitus was more common in men, but neither condition showed a significant association with the outcomes (P> 0.05). Most deaths were associated with thromboembolism, acute kidney injury, and heart failure, and valve origin had no significant impact on mortality.

Conclusions

In our tertiary care center, we observed a mortality rate of 7.24% after prosthetic heart valve implantation in all age groups over the past five years. While trends suggested potentially higher mortality rates in female and older patients, these differences were not statistically significant. The in-hospital mortality rate of 7.24% is consistent with studies conducted in India but exceeds levels reported in Western data. This increased mortality in Indian patients could be due to delayed surgeries, which often lead to right heart failure and organ dysfunction. In addition, improving long-term outcomes, such as: Reduction of thromboembolism, for example, remains an ongoing challenge in patients with mechanical valves. To improve long-term patient outcomes, it is critical to collect comprehensive data on delayed valve-related complications and mortality. Although this study is limited due to the small sample size and single-arm design, its results may provide valuable insights for the design of similar long-term, single-center, single-arm retrospective studies.

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