{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:02:30Z","timestamp":1784682150542,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Valvular heart disease (VHD) is a growing global health concern with increasing prevalence, particularly in aging populations. While surgical valve replacement (VRS) remains a definitive treatment, limited data exists from developing countries regarding postoperative outcomes. This study aimed to evaluate mid\u2010term clinical outcomes, specifically survival and major adverse cardiovascular events (MACE), in patients undergoing isolated mitral and aortic valve replacement surgery, and to identify factors associated with mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, 1044 patients who underwent isolated mitral or aortic VRS at Tehran Heart Center between 2003 and 2023 were analyzed. Demographic, clinical, and echocardiographic data were collected. The primary outcome was all\u2010cause mortality; the secondary outcome was MACE. Statistical analyses included univariate and multivariate Cox regression, ROC curve analysis, and log\u2010rank tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of patients was 55 years, and 52% were male. Over a mean follow\u2010up of 23.9 months, the overall mortality rate was 4.3%, and 8.4% experienced MACE. Multivariate analysis identified older age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and female gender (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) as independent predictors of mortality. Age\u2009&gt;\u200950 years had a sensitivity of 85.5% and specificity of 34% for predicting mortality (AUC\u2009=\u20090.639,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). No significant predictors of MACE were identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Advanced age and female gender were associated with increased mortality following isolated VRS. These findings underscore the importance of tailored preoperative risk assessment to optimize surgical outcomes, particularly in developing healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70276","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T06:16:27Z","timestamp":1761113787000},"page":"3943-3950","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mid\u2010Term Clinical Outcomes and Predictors of Mortality and Major Adverse Cardiovascular Events Following Cardiac Valve Replacement Surgery: A Retrospective Cohort Study From a Tertiary Center in Iran"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2193-0608","authenticated-orcid":false,"given":"Homina","family":"Saffar","sequence":"first","affiliation":[{"name":"Student Research Committee, Faculty of Medicine Mazandaran University of Medical Sciences Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6228-8447","authenticated-orcid":false,"given":"Nadia","family":"Rajablou","sequence":"additional","affiliation":[{"name":"School of Medicine Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbasali","family":"Karimi","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"},{"name":"Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrzad","family":"Salehbeygi","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheil","family":"Mansourian","sequence":"additional","affiliation":[{"name":"Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Pourhosseini","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arezou","family":"Zoroufian","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran 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Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Hosseinsabet","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohreh","family":"Lesani","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3834-9203","authenticated-orcid":false,"given":"Hamidreza","family":"Hekmat","sequence":"additional","affiliation":[{"name":"Cardiology Department, Baharlou Hospital, School of medicine Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samad","family":"Azari","sequence":"additional","affiliation":[{"name":"Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran Tehran Iran"},{"name":"Hospital Management Research Center, Health Management Research Institute Iran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2344-1661","authenticated-orcid":false,"given":"Negar","family":"Omidi","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Tehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"},{"name":"Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.019929"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.043391"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2025.101765"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2018.08.004"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.10.042"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.12.035"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.21470\/1678-9741-2019-0440"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2020-001339"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.202"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.08.083"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2023.10.006"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)03928-0"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.02.050"},{"issue":"4","key":"e_1_2_12_15_1","first-page":"163","article-title":"Factors 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