Multivariate analysis of risk factors for hospital mortality in valvular reoperations for prosthetic valve dysfunction

Brandão, Carlos Manuel de Almeida; Pomerantzeff, Pablo Maria Alberto; Souza, Luciano Rapold; Tarasoutchi, Flávio; Grimberg, Max; Ramires, José Antônio Franchini; Oliveira, Sérgio Almeida de

doi:10.1016/s1010-7940(02)00583-3

Cited by 33 publications

(17 citation statements)

References 17 publications

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“…It was reported in a study that advanced NYHA functional class was independent predictor of hospital mortality in patients submitted for valvular reoperations for prosthetic valve dysfunction [14]. In a failing heart, IABP represents an option of left ventricular support.…”

Section: Discussionmentioning

confidence: 99%

Predictors of in-hospital mortality following redo cardiac surgery: Single center experience

Çölkesen

Çoşkun

Çaylı

et al. 2015

IMAS

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Abstract:Purpose: Redo cardiac operations represent one of the main challenges in heart surgery. The purpose of the study was to analyze the predictors of in-hospital mortality in patients undergoing reoperative cardiac surgery by a single surgical team. Methods: A total of 1367 patients underwent cardiac surgical procedures and prospectively entered into a computerized database. Patients were divided into 2 groups based on the reoperative cardiac surgery (n = 109) and control group (n = 1258). Uni-and multivariate logistic regression analysis were performed to evaluate the possible predictors of hospital mortality. Results: Mean age was 56 ± 13, and 46% were female in redo group. In-hospital mortality was 4.6 vs. 2.2%, p = 0.11. EuroSCORE (6 vs. 3; p < 0.01), cardiopulmonary bypass time (90 vs. 71 min; p < 0.01), postoperative bleeding (450 vs. 350 ml; p < 0.01), postoperative atrial fi brillation (AF) (29 vs. 16%; p < 0.01), and inotropic support (58 vs. 31%; p = 0.001) were signifi cantly diff erent. These variables were entered into uni-and multivariate regression analysis. Postoperative AF (OR 1.76, p = 0.007) and EuroSCORE (OR 1.42, p < 0.01) were signifi cant risk factors predicting hospital mortality. Conclusions: Reoperative cardiac surgery can be performed under similar risks as primary operations. Postoperative AF and EuroSCORE are predictors of in-hospital mortality for redo cases.

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Section: Discussionmentioning

confidence: 99%

Predictors of in-hospital mortality following redo cardiac surgery: Single center experience

Çölkesen

Çoşkun

Çaylı

et al. 2015

IMAS

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“…The independent predictors of mortality in patients who underwent valvular reoperations for prosthetic valve dysfunction has been reported as; 1-advanced NYHA (New York Heart Association) functional class and 2-higher serum creatinine levels. The mortality rates observed were 9 % for reoperations in the aortic position and 12% in the mitral position (10,11).…”

Section: Introductionmentioning

confidence: 94%

The relation between location of paravalvular leakage and time to reoperation after mitral valve replacement: an observational study

Yanartaş

Demir²,

Baysal³

et al. 2013

Anadolu Kardiyol Derg

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Objective: A relation between the location of the paravalvular leakage (PVL) and time to reoperation after mitral mechanical valve replacement was investigated. Methods: In an observational retrospective study plan, from 59 patients who underwent reoperation only 47 patients having clinical and echocardiographic follow-up for five years were included into study. Depending on echocardiographic evaluation of location of leak, patients were divided into Group 1 (Leaflet) and Group 2 (Commissural). Demographics, preoperative variables, causes of reoperation, the time period between diagnosis of PVL and reoperation were recorded. Unpaired t test or Mann-Whitney U test were used for comparison of variables between groups. Results: A PVL was diagnosed after a median time of 180 days (range: 1 day-28 years) after the first mitral valve replacement. The median followup period was 5 years (range; 1-16 years). Age, gender, left ventricular ejection function, number and size of leaks did not differ between groups (p>0.05). The time period between diagnosis and reoperation time was longer in Group 1 in comparison to Group 2 (39.0±9.9 vs. 19.5±12.8 months, p=0.002). The 30-day mortality for valve reoperation was 4.3% (2/47). In Group 1, 2 patients (2/21, 9.8%) died whereas, no death was observed in Group 2 (0/26, 0%) (p=0.002). Conclusion:The time period between diagnosis and reoperation was longer in leaflet leak group in comparison to commissural leak group. We suggest echocardiographic evaluation should include location of the paravalvular leakage during follow-up of patients with PVL after mitral valve replacement. (Anadolu Kardiyol Derg 2014; 14: 61-7)

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“…Surgical closure of paravalvular leaks remains the most common therapy for these defects; however, re-do surgery has some limitations, depending on the number of patient comorbidities, including a high recurrence rate (7) as well as high morbidity and mortality rates (7)(8)(9). Furthermore, mortality increases progressively with the number of reoperations: 13% after the first, 15% after the second, and 37% after the third (9).…”

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confidence: 99%

Clinical Outcomes in Patients Undergoing Percutaneous Closure of Periprosthetic Paravalvular Leaks

Ruiz

Jelnin

Kronzon

et al. 2011

Journal of the American College of Cardiology

295

235

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Multivariate analysis of risk factors for hospital mortality in valvular reoperations for prosthetic valve dysfunction

Abstract: Advanced NYHA functional class and higher creatinine levels were independent predictors of hospital mortality in patients submitted for valvular reoperations for prosthetic valve dysfunction.

Cited by 33 publications

References 17 publications

Predictors of in-hospital mortality following redo cardiac surgery: Single center experience

Predictors of in-hospital mortality following redo cardiac surgery: Single center experience

The relation between location of paravalvular leakage and time to reoperation after mitral valve replacement: an observational study

Clinical Outcomes in Patients Undergoing Percutaneous Closure of Periprosthetic Paravalvular Leaks

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