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KMID : 0371619950110020207
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Journal of Wonkwang Medical Science
1995 Volume.11 No. 2 p.207 ~ p.214
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Clinical Study for Reoperation on Heart Valve Disease
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Choi Soon-Ho
Yang Heun-Woong
Lee Sam-Youn
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Abstract
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From January 1990 to June 1995 a total of 19 valvular reoperations performed in 14 patients with previously implanted prosthetic valves in Wonkwang University Hospital. There were 7 men and 7 women, mean age was 42.8±4.2 years. Mean time interval to reoperation was 79.2 ± 19.4 months. The indications for reoperations were prosthetic valve failure(6). prosthetic endocarditis(2). thrombotic prosthetic occlusion(2). severe TR with right heart failure(2). paravalvular leak(l), and restenosis of previous open mitral commissurotomy(l). Prosthetic valve failure developed most frequently in the mitral position. Mean intervals between primary valve operations and reoperation was 107.5±28.4 months in the case of prosthetic valve failure. The overall hospital mortality rate and late mortality rate were 0 %. Low cardiac output and postoperative massive bleeding were the most common cause of postoperative complications. The surgical risk of reoperation on heart valve prosthesis is higher than that of primary operations, but there is no conclusive evidence that the difference is stastically significant. Life expectancy may be reduced, but late survival can be improved, if conditions leading to myocardial damage are prevented, ie, reoperation is prompt when necessary.
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