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KMID : 0364019910240070663
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Korean Journal of Thoracic and Cardiovascular Surgery
1991 Volume.24 No. 7 p.663 ~ p.668
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Clinical Analysis of Reoperations on Prosthetic Valve Failure
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최병철/Choi, B.C.
유환국/안욱수/허용/김병열/이정호/Yoo, H.K./Ahn, W.S./Hur, Y./Kim, B.Y./Yoo, H.S.
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Abstract
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To evaluate risks, complications and mortality of reoperations on heart valve prosthesis, we reviewed clinical records of 53 patients who underwent reoperation because of prosthetic valve failure(PVF), from Jan. 1959 through Jun. 1991. They had undergone 48 mitral, 10 aortic valve rereplacement. Primary tissue failure was the main cause of reoperation : it occurred in 51 valves at a mean postoperative interval of 58 months. Calcification and collagen disruption of prosthesis were main causes of primary tissue failure in macro and micropathology. In 3 failing mechanical prostheses, paravalvular leak was in 2 cases, another one case had the thrombi at the hinge portion. If conditions such as emergency operation with or without endocarditis, thromboembolism and advanced NYHA functional class are -prevented, we think that reoperative valve replacement has similar morbidity and mortality to initial valve replacement surgery. But our stu_ dy represents higher mortality (22.6%) because of late surgical intervention failing the prevention of conditions leading to myocardial damage.
In conclusion if the tearing, calcification, and a new murmur were detected the early reoperation should be considered to increase late survival.
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