Reoperations for Valve Surgery: Perioperative Mortality and Determinants of Risk for 373 Patients,1984-1993

Bayer ÇINAR, Remzi TOSUN, Murat KONUK, Kemal YEŞİLÇİMEN, Mehmet GÜNEY, Abdullah TUYGUN, Kadir GÜRKAN, Sami ÜNAL, Özge SEZERMAN

İstanbul Üniversitesi Göğüs Kalp Damar Cerrahi Merkezi

373 cardiac reoperation for vale surgery were revieved to determine in hospital mortality and indi cators of risk. Subgroups based on number of previous cardiac procedures and the valve or valves replaced or repaired at reoperation (aortic valve, mitral valve, tricuspid valve, or multle valvesand mortality Ideaths /numberof procedures (% mortality)I) for those subgroups are as follows;

Aort Mitral Triküspid Multiple

Kapak Kapak Kapak Kapak Total

Reoperasyon 4/20(%20) 25/155 (%16) 4/19(%21) 27/162(%16.6) 63/373(%16)

Predictors of increased risk for a first aortic valve reoperation were advanced age (p=0.0002), endocarditis (p=0.0018), impraired left ventricular function (p=0.06), male sex (p=0.01). For a mitral valve reoperation, the predictors were advandage (pp<0.001), preoperative shock or cardiac arrest (p=0.01), previous aortic or tricuspid valve operations (p=0.02). Type of mitral valve procedure (risk for repair of periprosthetic leak was greater than mitral valve conserving operation Ip=0.05I ,and impaired left entricular function (p=0.06). For a multiple valve reopatiton, the predictors were diabetes (p=0.04) and ascites (p=0.02). Age is the most consistent predictor of risk for patients undergoing valve reoperations.

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	Aort	Mitral	Triküspid	Multiple
	Kapak	Kapak	Kapak	Kapak	Total
Reoperasyon	4/20(%20)	25/155 (%16)	4/19(%21)	27/162(%16.6)	63/373(%16)