Reoperative Aortic Valve Replacement After Previous Coronary Artery Bypass Grafting or Aortic Valve Replacement

Lee, Anson M.; Moon, Marc R.

doi:10.1053/j.optechstcvs.2015.04.001

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…The innominate artery will almost never have scar around it from the primary operation. The innominate artery can be cannulated directly or a side arm graft can be sewn to it [Lee 2014]. This technique is also described in the congenital cardiac literature.…”

Section: E68mentioning

confidence: 99%

Reoperative Cardiac Surgery: Part I – Preoperative Planning

Tribble

2018

HSF

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While reoperative cardiac surgery has become safer in recent years, it is still more difficult and dangerous than a primary operation. In a recent review of the Cleveland Clinic's experience, 7% of the patients undergoing cardiac reoperations had major intraoperative adverse events (IAEs). In that report, if an IAE occurred, there was a 5% mortality and a 19% incidence of myocardial infarction (MI), stroke, or death [Roselli 2011]. Those are sobering statistics, particularly when reported by one of the busiest cardiac surgical services in the world. The take-home message is that reoperative cardiac surgery is riskier than primary cardiac operations and that there are strategies that should be employed at each juncture to lower the risks of a reoperation.However, many of these strategies and recommendations have been more implicit than explicit. In fact, surprisingly little has been written about reoperative cardiac surgery. Thus, it seems appropriate to collect some of the lessons, adages, tricks, and tools that might make reoperations a click safer.

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Section: E68mentioning

confidence: 99%

Reoperative Cardiac Surgery: Part I – Preoperative Planning

Tribble

2018

HSF

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“…Previous cardiac surgery (PCS) has been considered a predictor for adverse outcomes in patients undergoing aortic valve replacement (AVR). This may be due to the higher risk profile of patients that are submitted to a second surgery compared to those with first time surgery (FTS) and that the technique for reoperation is generally more demanding [1,2] . Reoperation, either in patients with previous prosthetic valve replacement [3] or coronary artery bypass grafting (CABG) [4] have not proven to be risk factors for operative mortality in re-do AVR [5] .…”

Section: Introductionmentioning

confidence: 99%

Previous Cardiac Surgery: a Predictor of Mortality in Aortic Valve Replacement?

Dayan¹,

Arocena²,

Fernández³

et al. 2019

Braz J Cardiovasc Surg

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Introduction Previous cardiac surgery (PCS) is a risk factor for operative mortality in pa-tients undergoing reoperative aortic valve replacement (AVR) and may be influenced by the volume of patients in each center. The aim of this study was to evaluate the results of AVR in patients with previous cardiac surgery in a low volume cardiac center (400 cases per year). Methods Between January 2006 and December 2016, 854 patients underwent isolated AVR surgery at our institution. Of these, 70 had PCS. Propensity match (PM) was per-formed to balance basal covariates. Operative mortality and survival were the primary outcomes. Results The PCS and first-time surgery (FTS) groups had significant differences in base-line characteristics (PCS group were older, higher incidence of hypertension, endocarditis, NYHA III/IV, lower LVEF, higher creatinine and higher EuroSCORE). In the unmatched population, patients with PCS had higher operative mortality (17.1% vs . 4.6%, P =0.001). In the PM groups, this difference was not significant (12.5% and 3.6%, P =0.08). The only independent predictors for operative mortality found in the PCS group were age and fe-male gender. Age and diabetes were identified as the only independent predictors of sur-vival. Conclusion PCS was not a predictor for operative mortality nor long-term survival in pa-tients undergoing isolated aortic valve replacement.

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Reoperative Aortic Valve Replacement After Previous Coronary Artery Bypass Grafting or Aortic Valve Replacement

Cited by 2 publications

References 18 publications

Reoperative Cardiac Surgery: Part I – Preoperative Planning

Reoperative Cardiac Surgery: Part I – Preoperative Planning

Previous Cardiac Surgery: a Predictor of Mortality in Aortic Valve Replacement?

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