Abstract
Between September 1968 and October 1987, 152 patients (66 males and 86 females; age range, 15 to 79 years) underwent 1 or more reoperations (total, 179) for prosthetic valve dysfunction at our hospital. In this report, we present material and statistics reflecting our experience with the last reoperation in these 152 patients. The procedures involved the mitral valve in 93 patients, the aortic valve in 38 patients, double valves (aortic and mitral) in 19, and the tricuspid valve in 2. Sixty-five patients were operated on for mechanical valve dysfunction, and 87 for tissue valve dysfunction.
The modes of valve dysfunction that indicated surgery were primary valve failure (85 patients), valvular thrombosis and valve-related thromboembolic episodes (27 patients), paravalvular leak (25 patients), prosthetic valve endocarditis (14 patients), and hemolysis (1 patient). Three patients were in New York Heart Association functional Class II, 77 were in Class III, and 61 were in Class IV; the remaining 11 cases were emergencies. The 30-day operative mortality was 14.5%, the 5-year survival was 75%, and the 10-year survival was 63%. The preoperative functional class and the mode of valve dysfunction significantly influenced both early and late mortality. (Texas Heart Institute Journal 1990;17:106-11)
Keywords: Valvular heart disease
Keywords: prosthetic valve dysfunction
Keywords: repeat valve replacement
Keywords: thrombosis
Keywords: paravalvular leak
Keywords: endocarditis
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baumgartner W. A., Miller D. C., Reitz B. A., Oyer P. E., Jamieson S. W., Stinson E. B., Shumway N. E. Surgical treatment of prosthetic valve endocarditis. Ann Thorac Surg. 1983 Jan;35(1):87–104. doi: 10.1016/s0003-4975(10)61436-1. [DOI] [PubMed] [Google Scholar]
- Bosch X., Pomar J. L., Pelletier L. C. Early and late prognosis after reoperation for prosthetic valve replacement. J Thorac Cardiovasc Surg. 1984 Oct;88(4):567–572. [PubMed] [Google Scholar]
- Calderwood S. B., Swinski L. A., Karchmer A. W., Waternaux C. M., Buckley M. J. Prosthetic valve endocarditis. Analysis of factors affecting outcome of therapy. J Thorac Cardiovasc Surg. 1986 Oct;92(4):776–783. [PubMed] [Google Scholar]
- Dismukes W. E., Karchmer A. W., Buckley M. J., Austen W. G., Swartz M. N. Prosthetic valve endocarditis. Analysis of 38 cases. Circulation. 1973 Aug;48(2):365–377. doi: 10.1161/01.cir.48.2.365. [DOI] [PubMed] [Google Scholar]
- Dobell A. R., Jain A. K. Catastrophic hemorrhage during redo sternotomy. Ann Thorac Surg. 1984 Apr;37(4):273–278. doi: 10.1016/s0003-4975(10)60728-x. [DOI] [PubMed] [Google Scholar]
- English T. A., Milstein B. B. Repeat open intracardiac operation. Analysis of fifty operations. J Thorac Cardiovasc Surg. 1978 Jul;76(1):56–60. [PubMed] [Google Scholar]
- Husebye D. G., Pluth J. R., Piehler J. M., Schaff H. V., Orszulak T. A., Puga F. J., Danielson G. K. Reoperation on prosthetic heart valves. An analysis of risk factors in 552 patients. J Thorac Cardiovasc Surg. 1983 Oct;86(4):543–552. [PubMed] [Google Scholar]
- Lansing A. M., Elbl F., Solinger R. E., Rees A. H. Left atrial-left ventricular bypass for congenital mitral stenosis. Ann Thorac Surg. 1983 Jun;35(6):667–669. doi: 10.1016/s0003-4975(10)61081-8. [DOI] [PubMed] [Google Scholar]
- Lytle B. W., Cosgrove D. M., Taylor P. C., Gill C. C., Goormastic M., Golding L. R., Stewart R. W., Loop F. D. Reoperations for valve surgery: perioperative mortality and determinants of risk for 1,000 patients, 1958-1984. Ann Thorac Surg. 1986 Dec;42(6):632–643. doi: 10.1016/s0003-4975(10)64597-3. [DOI] [PubMed] [Google Scholar]
- Macmanus Q., Okies J. E., Phillips S. J., Starr A. Surgical considerations in patients undergoing repeat median sternotomy. J Thorac Cardiovasc Surg. 1975 Jan;69(1):138–143. [PubMed] [Google Scholar]
- Orszulak T. A., Schaff H. V., Danielson G. K., Pluth J. R., Puga F. J., Piehler J. M. Results of reoperation for periprosthetic leakage. Ann Thorac Surg. 1983 Jun;35(6):584–589. doi: 10.1016/s0003-4975(10)61067-3. [DOI] [PubMed] [Google Scholar]
- Parr G. V., Kirklin J. W., Blackstone E. H. The early risk of re-replacement of aortic valves. Ann Thorac Surg. 1977 Apr;23(4):319–322. doi: 10.1016/s0003-4975(10)64132-x. [DOI] [PubMed] [Google Scholar]
- Rossiter S. J., Miller D. C., Stinson E. B., Oyer P. E., Reitz B. A., Shumway N. E. Aortic and mitral prosthetic valve reoperations: early and late results. Arch Surg. 1979 Nov;114(11):1279–1283. doi: 10.1001/archsurg.1979.01370350081008. [DOI] [PubMed] [Google Scholar]
- Sandza J. G., Jr, Clark R. E., Ferguson T. B., Connors J. P., Weldon C. S. Replacement of prosthetic heart valves. A fifteen-year experience. J Thorac Cardiovasc Surg. 1977 Dec;74(6):864–874. [PubMed] [Google Scholar]
- Stewart S., DeWeese J. A. The determinants of survival following reoperation on prosthetic cardiac valves. Ann Thorac Surg. 1978 Jun;25(6):555–557. doi: 10.1016/s0003-4975(10)63608-9. [DOI] [PubMed] [Google Scholar]
- Syracuse D. C., Bowman F. O., Jr, Malm J. R. Prosthetic valve reoperations. Factors influencing early and late survival. J Thorac Cardiovasc Surg. 1979 Mar;77(3):346–354. [PubMed] [Google Scholar]
- Wideman F. E., Blackstone E. H., Kirklin J. W., Karp R. B., Kouchoukos N. T., Pacifico A. D. Hospital mortality of re-replacement of the aortic valve. Incremental risk factors. J Thorac Cardiovasc Surg. 1981 Nov;82(5):692–698. [PubMed] [Google Scholar]
- Wilson W. R., Jaumin P. M., Danielson G. K., Giuliani E. R., Washington JA I. I., Geraci J. E. Prosthetic valve endocarditis. Ann Intern Med. 1975 Jun;82(6):751–756. doi: 10.7326/0003-4819-82-6-751. [DOI] [PubMed] [Google Scholar]
- Wisheart J. D., Ross D. N., Ross J. K. A review of the effect of previous operations on the results of open-heart surgery. Thorax. 1972 Mar;27(2):137–142. doi: 10.1136/thx.27.2.137. [DOI] [PMC free article] [PubMed] [Google Scholar]
- de Bruin M. J., Lacquet L. K., Skotnicki S. H., Vincent J. G., van der Meer J. J. Reoperation for prosthetic heart valve replacement. Thorac Cardiovasc Surg. 1986 Feb;34(1):12–16. doi: 10.1055/s-2007-1020364. [DOI] [PubMed] [Google Scholar]
