Risk of reoperation for structural failure of aortic and mitral tissue valves

Abstract

In order to assess the risk of reoperation in the case of a failing stented tissue valve, 259 patients (118 males, 141 females; mean age 60.1 ± 15.4 years) underwent redo valve replacement. Of these patients, 94 (36.3%) underwent redo aortic valve replacement (AVR), 105 (40.5%) redo mitral valve replacement (MVR), and 60 (23.2%) redo aortic and mitral valve replacement (DVR). Twenty patients (7.7%) had previous coronary artery bypass grafting (CABG); further CABG were performed in 32 cases (12.4%). Preoperatively, 216 patients (83.3%) were in NYHA functional class III or IV. Early mortality was (6.5%; n = 17). A higher preoperative NHYA status (p <0.0004) and emergency surgery (p <0.0001) were associated with an increased risk of operative death. Age at operation (p = 0.45), previous CABG (p = 0.45), position of the valve replaced (p = 0.2), type of implant (p = 0.06) and presence of coronary artery disease (p = 0.51) were not associated with a significant risk of operative mortality. A failing tissue valve may be replaced, with acceptable operative mortality and morbidity. The trend towards reducing the age at which tissue valve implantation is performed may be justified