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The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 543-552, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
DG Husebye, JR Pluth, JM Piehler, HV Schaff, TA Orszulak, FJ Puga and GK Danielson
Five hundred fifty-two patients underwent a total of 617 reoperations for
repair or replacement of a prosthetic heart valve. Operative mortality for
first reoperation (530 patients) was 5.9% for the aortic position and 19.6%
for the mitral position. Overall operative mortality was 14% for second
reoperation (69 patients) and 7% for third reoperation (14 patients). In
addition to valve position, operative mortality for first reoperation
appeared to be related to pre- reoperation functional class and urgency of
operation. First reoperation for mitral valve patients in New York Heart
Association (NYHA) Class II was 4.2%; for Class III, 9.3%; and for Class
IV, 41%. In the aortic position, operative mortality was 2.4% for Class I,
1.6% for Class II, 6.3% for Class III, and 20.8% for Class IV. The
mortality for elective mitral valve reoperation was 0%; for urgent
operation, 20.3%; and for emergency procedures, 54.5%. Elective aortic
valve reoperation carried a 1.4% mortality; urgent procedures, 8%; and
emergency procedures, 37.5%. No significant differences in bleeding
complications were noted between reoperations and initial valve
replacement. The data appear to suggest that when significant valve
dysfunction is first noted, reoperation should be undertaken to minimize
operative risk.
ARTICLES
Reoperation on prosthetic heart valves. An analysis of risk factors in 552 patients
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