Reoperação em pacientes revascularizados

Pinto, Ibraim; Piegas, Leopoldo Soares; Mattos, Luiz Alberto; Tanajura, Luiz Fernando; Egito, Enilton T.; Neto, Camilo Abdulmassih; Arnoni, Antoninho S; Souza, Luiz Carlos Bento de; Jatene, Adib; Sousa, J. Eduardo M. R

doi:10.1590/s0102-76381987000300003

Cited by 1 publication

(2 citation statements)

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“…It is well known that reoperation is a highly demanding procedure performed in sicker patients which requires high surgical expertise [2] . Therefore, we believe that smaller cardiac surgery centers should rely on results provided by similar centers instead of underestimating the operative mortality of these procedures based on published results from high volume centers.…”

Section: Discussionmentioning

confidence: 99%

“…Previous cardiac surgery (PCS) has been considered a predictor for adverse outcomes in patients undergoing aortic valve replacement (AVR). This may be due to the higher risk profile of patients that are submitted to a second surgery compared to those with first time surgery (FTS) and that the technique for reoperation is generally more demanding [1,2] . Reoperation, either in patients with previous prosthetic valve replacement [3] or coronary artery bypass grafting (CABG) [4] have not proven to be risk factors for operative mortality in re-do AVR [5] .…”

Section: Introductionmentioning

confidence: 99%

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Previous Cardiac Surgery: a Predictor of Mortality in Aortic Valve Replacement?

Dayan¹,

Arocena²,

Fernández³

et al. 2019

Braz J Cardiovasc Surg

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Introduction Previous cardiac surgery (PCS) is a risk factor for operative mortality in pa-tients undergoing reoperative aortic valve replacement (AVR) and may be influenced by the volume of patients in each center. The aim of this study was to evaluate the results of AVR in patients with previous cardiac surgery in a low volume cardiac center (400 cases per year). Methods Between January 2006 and December 2016, 854 patients underwent isolated AVR surgery at our institution. Of these, 70 had PCS. Propensity match (PM) was per-formed to balance basal covariates. Operative mortality and survival were the primary outcomes. Results The PCS and first-time surgery (FTS) groups had significant differences in base-line characteristics (PCS group were older, higher incidence of hypertension, endocarditis, NYHA III/IV, lower LVEF, higher creatinine and higher EuroSCORE). In the unmatched population, patients with PCS had higher operative mortality (17.1% vs . 4.6%, P =0.001). In the PM groups, this difference was not significant (12.5% and 3.6%, P =0.08). The only independent predictors for operative mortality found in the PCS group were age and fe-male gender. Age and diabetes were identified as the only independent predictors of sur-vival. Conclusion PCS was not a predictor for operative mortality nor long-term survival in pa-tients undergoing isolated aortic valve replacement.

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Section: Discussionmentioning

confidence: 99%