Prognostic factors in mitral valve replacement surgery at Dr. Sardjito General Hospital, Yogyakarta-Indonesia

ABSTRACT
Background: The high morbidity following valve replacement surgery in mitral valve stenosis remains a big problem in the management of valvular heart disease in Indonesia. However, there has not been readily available data about the morbidity prognostic factors following mitral valve replacement surgery in the Indonesian population.
Method: A retrospective cohort of 60 patients at Dr. Sardjito general hospital from January 2011 to December 2014 were studied. The age, gender, ejection fraction, New York Heart Association (NYHA) functional class, angina Canadian Cardiovascular Society (CCS) grade 4, and postoperative morbidities were analyzed in the univariate and multivariate analysis using Medcalc.
Result: Ejection fraction, older age, and NYHA functional class were significantly related to postoperative morbidities (p-value < 0.05). Gender and angina CCS 4 were not significantly related to postoperative morbidities. Ejection fraction ≤ 50% showed the highest odds ratio related to postoperative morbidities (OR 5.645, 95% CI 1.134-0.027). NYHA functional class 3 showed postoperative morbidities odds ratio of 3.200 (95% CI 2.240-23.065), while age ≥ 50 years OR was 2.445 (95% CI 2.250-24.500).
Conclusion: Ejection fraction ≤ 50%, age ≥ 50 years, and NYHA functional class 3 are significantly associated with worse outcome after mitral valve replacement surgery.