Decrease in operative risk of reoperative valve surgery

Cohn, Lawrence H.; Aranki, Sary F.; Rizzo, Robert J.; Adams, David H.; Cogswell, Kimberly A.; Kinchla, Nancy M.; Couper, Gregory S.; Collins, John J.

doi:10.1016/0003-4975(93)90397-z

Cited by 91 publications

(65 citation statements)

References 19 publications

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“…4,7,8,22 However, the mortality has steadily declined with improvements in surgical technique, 5,14,23 and several recent studies have reported reoperative mortality rates similar to that of primary AVR. 9,11,13 Our patients had an excellent 30-day operative mortality rate of 2.5%, which is significantly lower than other studies which reported rates of 4.5 to 10.6%.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Outcomes of Patients With Severe Bioprosthetic Aortic Valve Stenosis Undergoing Redo Surgical Aortic Valve Replacement

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Characteristics and Outcomes of Patients With Severe Bioprosthetic Aortic Valve Stenosis Undergoing Redo Surgical Aortic Valve Replacement

et al. 2015

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“…17) The risk of valve re-replacement was analyzed in 640 patients in a large-scale study, and the overall operative mortality was shown to improve with each passing year. 18) The most common indications for redo aortic valve replacement (AVR) are bioprosthetic structural valve degeneration, PVE, PVLs, and thrombosis or pannus formation in mechanical aortic valves. 19) While pannus is common to both biological and mechanical valves, acute prosthetic thrombosis is a complication that is mostly associated with mechanical valves.…”

Section: Surgical Indication and Risk Analysismentioning

confidence: 99%

“…An increasing number of elderly patients are being referred for repeat surgical interventions for valvular heart disease. Based on clinical results showing 6.8%-10.0% overall mortality in patients with redo valvular surgery, 16,18,55) redo valvular surgery can be performed in an elderly cohort with acceptable morbidity and mortality. 56) These results suggest that advanced age and the need for reoperation is not a contraindication to conventional surgical interventions.…”

Section: Redo Valve Surgery In Elderly Patientsmentioning

confidence: 99%

Redo Valve Surgery—Current Status and Future Perspectives

Furukawa

Tanemoto

2014

ATCS

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Surgeons are now facing the challenge of redo valve surgery because of the increasing number of elderly individuals in Japan. The incidence of bioprosthesis dysfunction has increased among the various surgical indications of redo valve surgery due to the preference of patients and a paradigm shift in prostheses from mechanical valves to bioprostheses. Previous studies reported that the clinical outcomes of reoperative valvular surgery have markedly improved due to the maneuver of myocardial protection, cardiopulmonary bypass strategies, and appropriate safer surgical approach. The general surgical outcomes of redo valve surgery have been reported as being similar to those of primary valve surgery; however, this is still controversial and has not yet been confirmed in some developed countries. Although the unique surgical technique of transcatheter valve-in-valve implantation for bioprosthetic dysfunction is promising, redo valve surgery may become more prevalent in the future. We here reviewed the current status of reoperative valve surgery and future perspectives including catheter-based surgical interventions.

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“…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: 42%

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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Decrease in operative risk of reoperative valve surgery

Cited by 91 publications

References 19 publications

Characteristics and Outcomes of Patients With Severe Bioprosthetic Aortic Valve Stenosis Undergoing Redo Surgical Aortic Valve Replacement

Characteristics and Outcomes of Patients With Severe Bioprosthetic Aortic Valve Stenosis Undergoing Redo Surgical Aortic Valve Replacement

Redo Valve Surgery—Current Status and Future Perspectives

Repeat valve surgery: An analysis of 182 patients

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