Risk Factors of Redo-valve Replacement.
- Author:
Kang Joo CHOI
1
;
Kwang Hyun CHO
;
Sung Ryong KIM
;
Sang Gwon LEE
;
Hee Jae JUN
;
Young Chul YOON
;
Yang Haeng LEE
;
Youn Ho HWANG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University, Korea. ctsckh@ijnc.inje.ac.kr
- Publication Type:Original Article
- Keywords:
Reoperation;
Bioprosthesis;
Heart valve prosthesis
- MeSH:
Bioprosthesis;
Body Surface Area;
Endocarditis;
Heart Valve Prosthesis;
Hospital Mortality;
Humans;
Mortality;
Postoperative Complications;
Renal Insufficiency;
Reoperation;
Retrospective Studies;
Risk Factors*;
Ventricular Function, Left
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2002;35(11):785-791
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The results of reoperative valve replacement can be improved if appropriate analysis for the risk of reoperation was achieved. The purpose of our study was to analyze the results of reoperations for failure of bioprosthesis, and to define the risk factors in high-risk populations for reoperative procedures. MATERIAL AND METHOD: The series of 46 consecutive patients who had undergone first reoperative replacement for failed bioprosthesis between 1993 and 2001 were reviewed retrospectively. Mean age was 42+/-12 years, mean body surface area was 1.52+/-0.15 m2. The reoperative procedure comprised of 36 MVR, 8 DVR, and 2 AVR. The first operation comprised of 2 DVR, 1 AVR, and 43 MVR. Factors which were choose to assess a predictor of results in reoperative valve replacement were sex, old age(>60 years), early age at first operation(<30 years), long interval between first and redo operation(>15years), poor NYHA functional class(>3), LV dysfunction(LVEF<45%), long operation time(>8hours), endocarditis, combined procedures, and renal insufficiency. RESULT: Overall mortality was 4.3%(2 cases). The risk factors that influenced postoperative complications and unexpected postoperative results were lower ejection fraction(p=0.012), older age(p=0.045), endocarditis(p=0.023), long operation time above 8 hours(p=0.027). There was no statistically significant factor influencing hospital mortality. CONCLUSION: No factor influenced the mortality. Better results could be achieved if reoperation was performed carefully in poor left ventricular function, old aged patient, and with endocarditis. Effort to shorten the operation time would be helpful on postoperative results.
