Objectives: The burden of valvular heart disease (VHD) is high and increasing all around the world due to aging of the population. The etiologic factors of VHD are different among countries. There is little data about etiologic factors of VHD in Iran. The aim of present study was to determine the associated factors related to the 5-year survival and mortality rate of patients undergoing bileaflet mechanical valve replacement.
Methods: In this retrospective cohort study, demographic, electrocardiographic and echocardiographic data of patients who had underwent aortic, mitral and tricuspid valve replacement with bileaflet valves in the Afshar Hospital in Yazd, Iran, between March 2008 to February 2015 were obtained from their records. Supplementary information like hemorrhagic or thromboembolic events, rehospitalization and death during follow-up were gathered through contact with patients. For analysis of the data, SPSS ver. 19 was used.
Results: Four hundred and thirty eight patients entered the study. Male gender was slightly predominant (%53). Mean age of the patients was 51.6 ± 17.4 years. The rate of in-hospital mortality was 9.8% while the 5-year survival rate was 82.42%. The rate of major thromboembolic events was 0.97%/year and that of major hemorrhagic events was 0.5%/year. Patients with older age, lower cardiac ejection fraction (less than 30%) and with atrial fibrillation had a higher rate of mortality (P = 0.001). In-hospital mortalities were 3%, 9%, 12% and 15% for AVR, AVR+MVR, MVR and CABG+valvular surgery, respectively.
Conclusions: Higher rate of mitral valve surgery in this study may be due to possible predominance of rheumatic valvular pathology similar to other developing countries. Rate of 5-year survival, thromboembolic and hemorrhagic rates were acceptable and comparable to global reports.