ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Reoperation for bioprosthetic mitral valve dysfunction early and late-term risk analysis
Hasan Basri Erdoğan, Kaan Kırali, Murat Rabuş, Vedat Erentuğ, Nihan Kayalar, Nilgün Bozbuğa, Mustafa Güler, Esat Akıncı, Cevat Yakut
Department of Cardiovascular Surgery, Kartal Koşuyolu Heart and Research Hospital, İstanbul
Background:essment of risk factors affecting early and late outcomes of reoperation for bioprosthetic mitral valve dysfunction in patients with rheumatic heart disease and analysis of long-term prognosis of such operations.

Methods: Between 1985 and 2004, we performed reoperations for bioprosthetic valve dysfunction to 104 patients (95 women, 9 men; mean age 48.5±11.3 years; range 20 to 73 years). Causes of bioprosthetic valve dysfunction were structural degeneration in 99 patients, infective endocarditis in two patients and paravalvular leak in three patients.

Results: hospital mortality was 8.7% (9 patients). Multivariate analysis showed that tricuspid repair in the first operation (p=0.03; Odds ratio 22.7, 95%CI 1.2-423.7), pulmonary hypertension (p=0.03; Odds ratio 24.8, 95%CI 1.3- 475.8), and concomitant tricuspid valve repair in the reoperation (p=0.03, Odds ratio 22.7, %95CI 1.2-423.8) were significant risk factors for early mortality. Patients with initial tricuspid disease at the first operation had worse early outcome compared to patients without tricuspid pathology (p=0.038). Late mortality was 2.9% (3 patients). No statistically significant risk factor for late mortality was identified. The ten-year survival rate was 85.6%±4.35.

Conclusion: study suggests that reoperation for bioprosthetic mitral valve dysfunction should be performed prior to development of pulmonary hypertension. Rheumatic tricuspid valve disease requiring repair at first operation and/or at reoperation has a poor effect on the early outcome of reoperation.

Keywords : Bioprosthesis; mitral valve; reoperation; tricuspid valves
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