{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T11:15:09Z","timestamp":1771931709194,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Rheumatic heart disease (RHD) remains prevalent in developing regions, often leading to significant valvular damage. This study aimed to assess whether the start time of heart valve replacement surgery influences short-term clinical outcomes in patients with rheumatic heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis included 300 adult patients who underwent elective valve replacement surgery between January 2020 and January 2023. Patients were divided into two groups based on surgery start time: morning (AM group: 7 a.m.\u20131 p.m.) and afternoon (PM group: after 1 p.m.). Propensity score matching and logistic regression were used to compare mortality, complications, intensive care unit (ICU) stay, and hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 283 patients were analyzed (AM: 137, PM: 146). No significant differences were found between groups in postoperative mortality (odds ratios\u2009=\u20090.31,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.17), bleeding reoperation (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.70), blood product usage (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.60), ICU stay (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.12), ventilation time (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.37), or hospitalization cost (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.40). However, total hospitalization time was longer in the AM group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01), influenced by factors such as cardiac function, liver insufficiency, and surgical complexity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgery start time did not significantly affect short-term outcomes in patients with rheumatic heart disease undergoing valve replacement. Differences in hospital stay duration may be attributable to patient-specific factors and surgical complexity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1693694","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T05:22:44Z","timestamp":1770960164000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of heart valve replacement surgery start time on patients with rheumatic heart disease"],"prefix":"10.3389","volume":"13","author":[{"given":"Chonggang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Guizhou Provincial People\u2019s Hospital","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songsong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Guizhou Provincial People\u2019s Hospital","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Guizhou Provincial People\u2019s Hospital","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenbin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Guizhou Provincial People\u2019s Hospital","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"100219","DOI":"10.1016\/j.shj.2023.100219","article-title":"Rheumatic heart disease in the developing world","volume":"7","author":"Simpson","year":"2023","journal-title":"Struct 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transplant","volume":"305","author":"George","year":"2011","journal-title":"JAMA"},{"key":"B12","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.jtcvs.2019.11.131","article-title":"Daytime variation does not impact outcome of cardiac surgery: results from a diverse, multi-institutional cardiac surgery network","volume":"162","author":"Nemeth","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1053\/j.jvca.2016.08.015","article-title":"Surgery start time does not impact outcome in elective cardiac surgery","volume":"31","author":"Heller","year":"2017","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"B14","volume-title":"Stata Statistical Software: Release 18","year":"2023"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1693694\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:28:15Z","timestamp":1771928895000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1693694\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":14,"alternative-id":["10.3389\/fcvm.2026.1693694"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1693694","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"article-number":"1693694"}}