Results
Median follow-up duration was 8.0 years. 70.5% of patients suffered
from rheumatic heart disease. 86.9% underwent mechanical double valve
replacement with tricuspid valve repair. There were six operative deaths
(9.84%), with the most common cause of death being multiorgan failure
(83.3%).
26.2% had a moderately elevated MELD-Na score of 9 to 15, and 4.9% had
a severely elevated score of >15. Patients with a MELD-Na
>9 had a higher unadjusted rate of operative mortality,
prolonged ventilation, need for dialysis and acute liver failure after
TVS.
Hierarchical logistic regression was performed using logistic EuroSCORE
as the base model. After risk adjustment, each point of MELD-Na score
increase was associated with 1.405 times increase in odds of operative
mortality. The regression analysis was repeated by incorporating
individual components of the MELD-Na score, including bilirubin, sodium,
and albumin. All three biochemical parameters were significantly
associated with operative mortality