Reoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment

Abstract

Background-The predominant complication of bioprostheses is structural valve deterioration and the consequences of reoperation. The purpose of the study was to determine the mortality and risk assessment of that mortality for mitral bioprosthetic failure.

Hospital outcome and predictors of operative mortality in redo MVR adult population

“…MV repair and mitral valvuloplasty) [16,19]. In our study, hospitaly mortality was (11.5%) which is concordant with the recent literature [3,5,12], despite the fact that 66.7% of our patients had concomitant procedures.…”

“…Despite the fact that recent years brought a substantial amelioration of repeat valve surgery results in terms of both clinical and functional outcomes, repeat valve surgery is a challenge [3]. It is also quiet conceivable that patients who had MVR are surviving longer and, therefore, they will need more redo operations due to prosthesis failure or valve-related complications.…”

“…Moreover, improved survival necessitated that more and more mitral patients become in need for repeat valve operations for a multiplicity of reasons such as structural valve degeneration, thrombosis, endocarditis and paravalvular leaks. However, there is some evidence now that clinical outcomes after repeat-valve surgery have improved which highlights the progress in this area [3]. Studies that investigate the operative morbidity and mortality, survival and freedom from re-intervention of patients undergoing redo-MVR with current techniques and prostheses are thus needed [4].…”

Which Valve to Who: Prosthetic Valve Selection for Aortic Valve Surgery

“…Among these prothesis, maximal clinical data exists about the porcine heterografts. Biological valves undergo some degeneration in every age and for that reason their long-term durability is influenced which results in a higher rate of valve reoperation (Brais 1985;Jamieson 2003;Gross 1998). In young patients this degeneration is seen more frequently because of the increased calcium turnover, fatigue-induced lesions and collagen degeneration, and discrete immunologic reaction (Berrebi 2001;Gross 1998;Salazar 1999;Badduke 1991;Sbarouni 1994).…”

Tissue Valve Is the Preferred Option for Patients Aged 60 and Older

“…Recent literature reports mortality of 5% to 7%, which is much decreased compared with old reports. [43][44][45] Previously placed bioprostheses will allow VIV transcatheter mitral valve replacement (TMVR) using the previous strut as an anchor. TMVR is currently not indicated for initial operation because of the lack of anchoring structure.…”