Morbidity and Mortality of Double Valve Replacement/Repair: A Cohort Study

Background: Aortic and mitral valve replacement or aortic valve replacement with mitral valve repair (DVR) is often associated with a higher risk of morbidity and mortality. Therefore, this study aimed to review and analyze the outcomes of DVR to identify factors associated with morbidity and mortality. Methods: Few multicenter data are available on the clinical outcomes of concomitant DVR in China. In four centers, we performed a cohort study of 816 patients who underwent DVR between January 2016 and December 2021. The 30-day mortality and a 6.5-year follow-up were assessed. Results: A total of 722 patients were included in the final analysis. Overall, the median cardiopulmonary bypass (CPB) time and aortic cross-clamp time were 164.5 minutes and 111 minutes, respectively. The overall 30-day mortality was 5.0% (n = 36). After propensity score matching (PSM), logistic regression analysis showed that EuroSCORE Ⅱ, preoperative ejection fraction (EF), and CPB duration were risk factors for death within 30 days. The median follow-up period was 1225.5 days. In total, 54 patients were lost during the follow-up; 61 patients died during the follow-up. Kaplan–Meier survival analysis revealed a cumulative survival rate of 86.0% at 6.5 years. Cox regression analysis identified ages ≥60 years and postoperative estimated glomerular filtration rates (eGFR) ≤65 mL/min/1.73 m2 as independent late mortality factors. Conclusions: Patients undergoing DVR still have a high risk of mortality and morbidity at 30 days and during follow-up. These patients aged ≥60 years and postoperative eGFR ≤65 mL/min/1.73 m2 are predictive of high mortality and poor prognosis during follow-up.