Repeat heart valve surgery: Risk factors for operative mortality

Jones, J. B.; O'Kane, Hugh; Gladstone, Dennis; Sarsam, Mazin A.I.; Campalani, Gianfranco; MacGowan, Simon W.; Cleland, Jack; Cran, G. W.

doi:10.1067/mtc.2001.116470

Cited by 213 publications

(163 citation statements)

References 11 publications

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“…When considering surgical procedures, the repair of periprosthetic valve leaks carries the highest risk, while conservative mitral valve surgery carries the lowest. [2,[9][10][11][12] Meanwhile, in our study the presence of emergency surgery, infective endocarditis, stuck valve, and infection were associated with early period mortality. On the other hand, gender, age, valve type used in the first operation, multiple valve surgery, and increased pulmonary artery pressure were unrelated.…”

Section: Discussionmentioning

confidence: 85%

“…Difficulty in exploration, the risk of bleeding, and incomplete myocardial protection are additional risk factors for patients requiring a second surgery. [2][3][4] In our study, while the incidence of repeat surgery among all valve replacement patients was 1% after one year, it increased up to 23% after that. We did not define pulmonary hypertension as an important risk factor for mortality.…”

Section: Discussionmentioning

confidence: 89%

“…In order to determine the indications for surgery, valve dysfunctions were evaluated under five different criteria: [2] 1. Prosthetic valve dysfunction: Valve dysfunction resulting from tissue ingrowth, mechanical dysfunction, and calcification or leaflet tears for bioprostheses …”

Section: Methodsmentioning

confidence: 99%

“…Death due to uncontrolled bleeding usually occurs because of left ventricle rupture after mitral valve replacement. [2,[14][15][16][17] In our series, the most common cause of death was also myocardial failure, and in two cases, it was due to left ventricle rupture and related uncontrolled bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…In the 1980s, the mortality rate was 9.4% for elective conditions and 42% for emergency conditions. [1,2] Recently, the mortality and morbidity rates of patients receiving a second valve replacement surgery have significantly decreased due to technological developments and increased experience. Reducing the surgical risk for patients undergoing a second surgery is possible with careful myocardial protection and minimal surgical dissection in conjunction with blood loss and limiting the usage of blood.…”

Section: Introductionmentioning

confidence: 99%

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Repeat valve surgery: An analysis of 182 patients

Özyazicioğlu¹

2012

Turk Gogus Kalp Dama

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Background: In this study, we aimed to investigate the preoperative and operative risk factors in patients undergoing valve replacement for the second time, including the types of valves and surgical methods used. Methods: Between January 1994 and December 2009, a total of 2089 valve replacements were performed in our clinic, and 182 (112 females, 70 males) of these operations (8.7%) were repeat valve surgeries. Results: The mean age for repeat surgery was 49.2±27.4 years while the mean time elapsed between the first and second surgeries was 11.8±5.7 years. The follow-up period after repeat surgery was 2.6±1.3 years. Bioprosthesis valves were removed from a total of 142 patients (78%), and mechanical valves were removed from 40 patients (22%). In total, 221 valves were replaced. The total number of valves implanted was 219, and valve repair alone was performed on three patients. Of the valves implanted in repeat surgery, 197 (90%) were mechanical valves. The preoperative echocardiography findings revealed that the major problem (84%) observed was valve dysfunction, followed by infection. Fifteen patients (8.2%) who underwent repeat surgery died during the operation or within the first month afterwards. Conclusion:Repeat heart valve surgery may be performed using the standard surgical procedures with acceptable mortality. Factors increasing the probability of repeat surgery include emergency interventions and infections; however, pulmonary hypertension is not a factor that increases the probability of repeat valve replacement surgery.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Repeat valve surgery: An analysis of 182 patients

Özyazicioğlu¹

2012

Turk Gogus Kalp Dama

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Acute Mitral Interventions

Condado¹,

Calderas

Condado

2014

Urgent Interventional Therapies

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Percutaneous closure of an aortic prosthetic paravalvular leak with an Amplatzer duct occluder

Webb

Pate

Munt

2005

Cathet Cardio Intervent

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Following aortic valve replacement, up to 5% of patients may develop clinically significant paravalvular leaks. Reoperation is associated with higher mortality and an excess risk of recurrent paravalvular insufficiency. No specifically designed transcatheter device is available for paravalvular leak repair. We describe in a patient with severe aortic prosthetic paravalvular leak the use of an Amplatzer duct occluder device resulting in effective closure and symptomatic improvement.

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Repeat heart valve surgery: Risk factors for operative mortality

Abstract: Heart valve reoperations can be performed with an acceptable operative mortality. However, we have identified several categories of patients in whom reoperation carries an increased risk.

Cited by 213 publications

References 11 publications

Repeat valve surgery: An analysis of 182 patients

Repeat valve surgery: An analysis of 182 patients

Acute Mitral Interventions

Percutaneous closure of an aortic prosthetic paravalvular leak with an Amplatzer duct occluder

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