JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Potter, D. D.
Right arrow Articles by Orszulak, T. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Potter, D. D.
Right arrow Articles by Orszulak, T. A.
Related Collections
Right arrow Cardiac - other
Right arrow Valve disease

J Thorac Cardiovasc Surg 2005;129:94-103
© 2005 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Operative risk of reoperative aortic valve replacement

D. Dean Potter, MD, Thoralf M. Sundt, III, MD*, Kenton J. Zehr, MD, Joseph A. Dearani, MD, Richard C. Daly, MD, Charles J. Mullany, MD, Christopher G.A. McGregor, MD, Francisco J. Puga, MD, Hartzell V. Schaff, MD, Thomas A. Orszulak, MD

Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn

Read at the Eighty-fourth Annual Meeting of The American Association for Thoracic Surgery, Toronto, Ontario, Canada, April 25-28, 2004.

Received for publication April 23, 2004; revisions received July 22, 2004; accepted for publication August 10, 2004.

* Address for reprints: Thoralf M. Sundt III, MD, Division of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (E-mail: sundt.thoralf{at}mayo.edu).

OBJECTIVE: The contemporary risk of reoperative aortic valve replacement is ill-defined. We therefore compared the recent early results of reoperative and primary aortic valve replacement in our institution.

METHODS: Between January 1993 and January 2001, a total of 162 patients underwent reoperative aortic valve replacement with or without coronary artery bypass grafting, and 2290 underwent primary aortic valve replacement with or without coronary artery bypass grafting. The reoperative and primary groups were similar with regard to gender (37% female in both), preoperative New York Heart Association functional class (2.8 ± 1 vs 2.8 ± 1), and ejection fraction (58% ± 15% vs 57% ± 15%). Patients undergoing reoperative aortic valve replacement were younger than those undergoing primary aortic valve replacement (64 ± 15 years vs 70 ± 13 years, P < .001). Previous prostheses were xenografts in 77 patients (48%), homografts and autografts in 25 (15%), and mechanical prostheses in 60 (37%). Mean time to reoperation was 9.7 ± 6.8 years.

RESULTS: Early mortality for reoperative aortic valve replacement (8/162, 5%) was not statistically different from that for primary aortic valve replacement (71/2290, 3%, P = .20). Endocarditis was more common in the reoperative group (22% vs 3%, P < .001); when endocarditis was excluded from the analysis, early mortality was 3% in both groups. Multivariate predictors for early mortality were prosthetic valve endocarditis (P < .001, odds ratio 9.8), advanced preoperative functional class (P < .001, odds ratio 2.0), peripheral vascular disease (P = .008, odds ratio 2.0), preserved left ventricular ejection fraction (P = .004, odds ratio 0.98), and male gender (P = .009, odds ratio 0.49). After adjustment for these factors, there was no difference in early mortality between the groups (P = .095).

CONCLUSION: The risk of reoperative aortic valve replacement is similar to that for primary aortic valve replacement. These data support the expanded use of bioprosthetic valves in younger patients.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
P. Totaro, S. Carlini, M. Pozzi, F. Pagani, G. Zattera, A. M. D'Armini, and M. Vigano
Minimally invasive approach for complex cardiac surgery procedures.
Ann. Thorac. Surg., August 1, 2009; 88(2): 462 - 466.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
N. U. Khan and N. Yonan
Does preoperative computed tomography reduce the risks associated with re-do cardiac surgery?
Interactive CardioVascular and Thoracic Surgery, July 1, 2009; 9(1): 119 - 123.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
N. Khaladj, M. Shrestha, S. Peterss, I. Kutschka, M. Strueber, L. Hoy, A. Haverich, and C. Hagl
Isolated surgical aortic valve replacement after previous coronary artery bypass grafting with patent grafts: is this old-fashioned technique obsolete?
Eur. J. Cardiothorac. Surg., February 1, 2009; 35(2): 260 - 264.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. B. Lopes, L. A.O. Dallan, S. P. Campana-Filho, L. A.F. Lisboa, P. S. Gutierrez, L. F. P. Moreira, S. A. Oliveira, and N. A.G. Stolf
Keratinocyte growth factor: a new mesothelial targeted therapy to reduce postoperative pericardial adhesions
Eur. J. Cardiothorac. Surg., February 1, 2009; 35(2): 313 - 318.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
A Kulik, B-K Lam, F D Rubens, P J Hendry, R G Masters, W Goldstein, P Bedard, T G Mesana, and M Ruel
Gender differences in the long-term outcomes after valve replacement surgery
Heart, February 1, 2009; 95(4): 318 - 326.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
J. Kempfert, J. M. Blumenstein, M. A. Borger, A. Linke, S. Lehmann, P. Pritzwald-Stegmann, M. W.A. Chu, G. Schuler, V. Falk, F. W. Mohr, et al.
Minimally invasive off-pump valve-in-a-valve implantation: the atrial transcatheter approach for re-operative mitral valve replacement
Eur. Heart J., October 1, 2008; 29(19): 2382 - 2387.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll Cardiol IntvHome page
J. G. Byrne, M. Leacche, D. E. Vaughan, and D. X. Zhao
Hybrid Cardiovascular Procedures
J. Am. Coll. Cardiol. Intv., October 1, 2008; 1(5): 459 - 468.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. Roedler, M. Czerny, J. Neuhauser, D. Zimpfer, R. Gottardi, D. Dunkler, E. Wolner, and M. Grimm
Mechanical Aortic Valve Prostheses in the Small Aortic Root: Top Hat Versus Standard CarboMedics Aortic Valve
Ann. Thorac. Surg., July 1, 2008; 86(1): 64 - 70.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. L. Brown, H. V. Schaff, B. D. Lahr, C. J. Mullany, T. M. Sundt, J. A. Dearani, C. G. McGregor, and T. A. Orszulak
Aortic valve replacement in patients aged 50 to 70 years: Improved outcome with mechanical versus biologic prostheses.
J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 878 - 884.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
R. W. Emery, A. M. Emery, A. Knutsen, and G. V. Raikar
Aortic Valve Replacement with a Mechanical Cardiac Valve Prosthesis
Card. Surg. Adult, January 1, 2008; 3(2008): 841 - 856.
[Full Text]

Home page
 Card Surg AdultHome page
J. P. Greelish, R. M. Ahmad, J. M. Balaguer, M. R. Petracek, and J. G. Byrne
Reoperative Valve Surgery
Card. Surg. Adult, January 1, 2008; 3(2008): 1159 - 1174.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
M. A. Borger, K. Prasongsukarn, S. Armstrong, C. M. Feindel, and T. E. David
Stentless Aortic Valve Reoperations: A Surgical Challenge
Ann. Thorac. Surg., September 1, 2007; 84(3): 737 - 744.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. H.L. Tang, M. Maganti, T. E. David, C. M. Feindel, H. E. Scully, and M. A. Borger
Effect of Prior Valve Type on Mortality in Reoperative Valve Surgery
Ann. Thorac. Surg., March 1, 2007; 83(3): 938 - 945.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. N. Girardi, K. H. Krieger, C. A. Mack, L. Y. Lee, A. J. Tortolani, and O. W. Isom
Reoperations on the ascending aorta and aortic root in patients with previous cardiac surgery.
Ann. Thorac. Surg., October 1, 2006; 82(4): 1407 - 1412.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
A. I. Duncan, J. Lin, C. G. Koch, A. M. Gillinov, M. Xu, and N. J. Starr
The Impact of Gender on In-Hospital Mortality and Morbidity After Isolated Aortic Valve Replacement
Anesth. Analg., October 1, 2006; 103(4): 800 - 808.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. Gilard, J.-C. Cornily, P.-Y. Pennec, C. Joret, G. Le Gal, J. Mansourati, J.-J. Blanc, and J. Boschat
Accuracy of Multislice Computed Tomography in the Preoperative Assessment of Coronary Disease in Patients With Aortic Valve Stenosis
J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2020 - 2024.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. H. Jones
The Year in Cardiovascular Surgery
J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2094 - 2107.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. Luciani, G. Nasso, A. Anselmi, F. Glieca, M. Gaudino, F. Girola, M. Piscitelli, M. Perisano, L. Martinelli, and G. Possati
Repeat Valvular Operations: Bench Optimization of Conventional Surgery
Ann. Thorac. Surg., April 1, 2006; 81(4): 1279 - 1283.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
Determinants of operative mortality in valvular heart surgery.
J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 547 - 557.


Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. M. Davierwala, M. A. Borger, T. E. David, V. Rao, M. Maganti, and T. M. Yau
Reoperation is not an independent predictor of mortality during aortic valve surgery
J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 329 - 335.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 by The American Association for Thoracic Surgery.