Introduction
Mitral valve disease (MVD) is a common heart disease caused by rheumatic fever in most developing countries. For such diseases with clear indications, the most effective treatment is mitral valve surgery (repair, commissural incision, or valve replacement) [1]. However, the aortic valve disease (AVD) is present in up to 40% of patients with rheumatic MVD [2], and some patients who have undergone mitral valve surgery will develop AVD over time and may even need reoperation. Preoperative AVD in these patients is often mild to moderate. Concerning these patients, it has been controversial whether it is necessary to perform aortic valve surgery while dealing with the mitral valve. Since double valve replacement is more often associated with higher risk and poorer long-term survival than either of the two valves alone [3-4]. The decision of a surgical plan is often made by the surgeon during the operation. At present, there are few reports on the long-term outcomes and influencing factors of the aortic valve after single mitral valve surgery [5-8]. In this study, 144 patients who underwent mitral valve surgery (except for simultaneous aortic valve surgery) in Zhujiang Hospital of Southern Medical University from January 2010 to December 2016 were analyzed retrospectively. This study aimed to explore the predictors and to formulate clinical diagnosis and treatment strategies for the long-term progression of AVD after mitral valve surgery.