ArticleThe Annals of thoracic surgery2026
Long-Term Survival After Mitral Valve Replacement by Preoperative Risk: Implications for Patient Selection.
Article in The Annals of thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Bioprosthetic vs Mechanical Mitral Prosthesis: Age Is Just a Number.The Annals of thoracic surgery · 2026Article
- Long-Term Outcomes of Mechanical Mitral Valve Replacement: A Comparison of Four Valve Types.Journal of clinical medicine · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundMitral valve replacement (MVR) is recognized for its significant operative risks. This risk is commonly quantified with The Society of Thoracic Surgeons (STS) Risk Calculator. The present study aimed to investigate the long-term (5-year) predictive capabilities of the STS predicted risk of mortality (PROM) in patients undergoing isolated MVR.
methodsPatients undergoing isolated MVR at a high-volume mitral reference center from 2010-2023 were stratified by STS PROM (low: <3%, intermediate: 3%-6%, and high/extreme: >6%). Primary endpoints were short-term (30-day) and long-term (5-year) mortality. Kaplan-Meier survival analysis was used to compare short- and long-term survival among risk stratified groups. Cox regression modeling was used to identify predictors of long-term survival.
resultsOf 1444 of MVR patients, 855 patients underwent isolated MVR. The mean STS PROM for low, intermediate, and high/extreme-risk groups was 1.7%, 4.3%, and 12.7%, respectively. Thirty-day mortality was lower than predicted in the low (0.3%) and high/extreme risk (10.9%) groups. Five-year survival was 90.8%, 75.5%, and 56.4% respectively. Kaplan-Meier survival analysis at 5 years identified significant long-term survival probability differences among the PROM groups, even after accounting for perioperative risk (P < .001). Preoperative dialysis (hazard ratio [HR], 1.70; 95% CI 1.05-2.73; P = .03), hypertension (HR, 1.71; 95% CI, 1.13-2.59; P = .011), and urgent operative status (HR, 1.57; 95% CI, 1.09-2.26; P = .02) were among the characteristics associated with worse long-term survival.
conclusionsAlthough predictive models may overestimate surgical risk at high-volume mitral centers, the STS PROM correlates with 5-year mortality in isolated MVR. These findings may provide more specific risk stratification criteria, identifying patients best suited for operative intervention.
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