Repeat valve surgery: An analysis of 182 patients

Abstract

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.

Reoperation and Nursing Care

“…[30,31] Ayrıca bireyin ameliyat sonrası taburculuğunun planlanmasında, cerrahi hemşiresinin riskleri bilmesi ve alınacak önlemler konusunda hasta ve ailesini bilgilendirmesi gerekir. [35][36][37] Ikinci kez ameliyat olan hastaların genel olarak bir önceki ameliyata göre, kalp sorunları, hipertansiyon ve deri problemlerinin daha fazla görüldüğü belirtilmektedir. Hastaların kendini kötü hissettiği, infeksiyona yatkın olduğu, kan kaybının ve ağrısının ilk ameliyata göre daha fazla olduğu belirtilmektedir.…”