Impact of delayed presentation on short-term complications following mitral valve replacement for rheumatic mitral stenosis:A retrospective study

Abstract

Background: Rheumatic mitral stenosis (MS) remains a major cause of cardiovascular morbidity in low-resource settings. Delayed presentation often leads to advanced disease, increasing perioperative risk and short-term complications following mitral valve replacement (MVR). This study evaluates the impact of delayed presentation on short-term surgical outcomes in patients undergoing MVR for rheumatic MS. Methods: This retrospective study analysed data from 190 patients who underwent MVR for rheumatic MS at two public tertiary care hospitals in Central India between January 2021 and December 2023. Patients were categorized into early presentation (NYHA I–II, mild-moderate PAH, preserved biventricular function) and late presentation (NYHA III–IV, severe PAH, ventricular dysfunction) groups. Short-term outcomes, including ICU stay, mechanical ventilation duration, incidence of arrhythmias, acute kidney injury (AKI), sepsis, and mortality, were compared. Statistical analyses were performed using t-tests for continuous variables and chi-square tests for categorical variables.