ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Bruce W. Lytle
Delos M. Cosgrove
Paul C. Taylor
Carl C. Gill
Robert W. Stewart
Floyd D. Loop
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lytle, B. W.
Right arrow Articles by Loop, F. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lytle, B. W.
Right arrow Articles by Loop, F. D.

Ann Thorac Surg 1986;42:632-643
© 1986 The Society of Thoracic Surgeons


Articles

Reoperations for Valve Surgery: Perioperative Mortality and Determinants of Risk for 1,000 Patients, 1958–1984

Bruce W. Lytle, M.D.*, Delos M. Cosgrove, M.D., Paul C. Taylor, M.D., Carl C. Gill, M.D., Marlene Goormastic, M.P.H., Leonard R. Golding, M.D., Robert W. Stewart, M.D., Floyd D. Loop, M.D.

From the Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, OH

* Address reprint requests to Dr. Lytle, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106

One thousand consecutive cardiac reoperations for valve surgery in 897 patients were reviewed to determine in-hospital mortality and indicators of risk. Subgroups based on the number of previous cardiac procedures and the valve or valves replaced or repaired at reoperation (aortic valve, mitral valve, tricuspid valve, or multiple valves and mortality [deaths/number of procedures (% mortality)]) for those subgroups are as follows:


Aortic Valve Mihal Valve Tricuspid Valve Multiple Valves Total

Reoperation 1 26/239 (11%) 45/458 (10%) 2/10 (20%) 20/145 (14%) 93/852 (11%)
Reoperation 2 3/24 (13%) 9/77 (12%) 0/4 (0) 7/23 (30%) 19/128 (15%)
Reoperations 3-5 2/6 (33%) 5/10 (50%) 0/1 (0) 2/3 (67%) 9/20 (45%)

Predictors of increased risk for a first aortic valve reoperation were advanced age (p = .0002), endocarditis (p = .0018), female sex (p = .014), impaired left ventricular function (p = .039), and number of coronary vessels obstructed by 70% or more (p = .055). For a first mitral valve reoperation, the predictors were advanced age (p < .0001), preoperative shock or cardiac arrest (p = .01), previous aortic or tricuspid valve operations (p = .02), type of mitral valve procedure (risk for repair of periprosthetic leak was greater than mitral valve replacement which was greater than mitral valve–conserving operation [p = .05]), and impaired left ventricular function (p = .059). For a first multiple valve reoperation, the predictors were diabetes (p .04) and ascites (p = .02), whereas patients undergoing mitral valve replacement and tricuspid valve operations were at decreased risk (p = .01). Comparison of second reoperations with first reoperations indicates risk increases for multiple operations (p = .01) but not for aortic or mitral valve procedures. Rereplacement of a prosthesis (p = .007), coronary bypass grafting at reoperation (p = .006), and advanced age (p = .06) increased the risk for second reoperations. Age is the most consistent predictor of risk for patients undergoing valve reoperations.




This article has been cited by other articles:


Home page
ChestHome page
D. A. Garcia, T. P. Baglin, J. I. Weitz, and M. M. Samama
Parenteral Anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
Chest, February 1, 2012; 141(2_suppl): e24S - e43S.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
R. Gurvitch, A. Cheung, J. Ye, D. A. Wood, A. B. Willson, S. Toggweiler, R. Binder, and J. G. Webb
Transcatheter Valve-in-Valve Implantation for Failed Surgical Bioprosthetic Valves.
J. Am. Coll. Cardiol., November 15, 2011; 58(21): 2196 - 2209.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
S. Leontyev, M. A. Borger, P. Modi, S. Lehmann, J. Seeburger, T. Walther, and F. W. Mohr
Redo aortic valve surgery: Influence of prosthetic valve endocarditis on outcomes
J. Thorac. Cardiovasc. Surg., July 1, 2011; 142(1): 99 - 105.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll Cardiol IntvHome page
N. Piazza, S. Bleiziffer, G. Brockmann, R. Hendrick, M.-A. Deutsch, A. Opitz, D. Mazzitelli, P. Tassani-Prell, C. Schreiber, and R. Lange
Transcatheter Aortic Valve Implantation for Failing Surgical Aortic Bioprosthetic Valve: From Concept to Clinical Application and Evaluation (Part 1)
J. Am. Coll. Cardiol. Intv., July 1, 2011; 4(7): 721 - 732.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
L. B. Balsam, E. A. Grossi, D. G. Greenhouse, P. Ursomanno, A. DeAnda, G. H. Ribakove, A. T. Culliford, and A. C. Galloway
Reoperative Valve Surgery in the Elderly: Predictors of Risk and Long-Term Survival
Ann. Thorac. Surg., October 1, 2010; 90(4): 1195 - 1201.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
D. J. LaPar, Z. Yang, G. J. Stukenborg, B. B. Peeler, J. A. Kern, I. L. Kron, and G. Ailawadi
Outcomes of reoperative aortic valve replacement after previous sternotomy
J. Thorac. Cardiovasc. Surg., February 1, 2010; 139(2): 263 - 272.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
M. Maganti, V. Rao, S. Armstrong, C. M. Feindel, H. E. Scully, and T. E. David
Redo Valvular Surgery in Elderly Patients
Ann. Thorac. Surg., February 1, 2009; 87(2): 521 - 525.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll Cardiol IntvHome page
J. G. Byrne, M. Leacche, D. E. Vaughan, and D. X. Zhao
Hybrid Cardiovascular Procedures
J. Am. Coll. Cardiol. Intv., October 1, 2008; 1(5): 459 - 468.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
E. R. Nowicki, G. B. Pettersson, N. G. Smedira, E. E. Roselli, E. H. Blackstone, and B. W. Lytle
Aortic Allograft Valve Reoperation: Surgical Challenges and Patient Risks
Ann. Thorac. Surg., September 1, 2008; 86(3): 761 - 768.
[Abstract] [Full Text] [PDF]


Home page
Card Surg AdultHome page
J. P. Greelish, R. M. Ahmad, J. M. Balaguer, M. R. Petracek, and J. G. Byrne
Reoperative Valve Surgery
Card. Surg. Adult, January 1, 2008; 3(2008): 1159 - 1174.
[Full Text]


Home page
Ann. Thorac. Surg.Home page
G. H.L. Tang, M. Maganti, T. E. David, C. M. Feindel, H. E. Scully, and M. A. Borger
Effect of Prior Valve Type on Mortality in Reoperative Valve Surgery
Ann. Thorac. Surg., March 1, 2007; 83(3): 938 - 945.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
N. Luciani, G. Nasso, A. Anselmi, F. Glieca, M. Gaudino, F. Girola, M. Piscitelli, M. Perisano, L. Martinelli, and G. Possati
Repeat Valvular Operations: Bench Optimization of Conventional Surgery
Ann. Thorac. Surg., April 1, 2006; 81(4): 1279 - 1283.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
J. M. Bernal, D. Morales, C. Revuelta, J. Llorca, J. Gutierrez-Morlote, and J. M. Revuelta
Reoperations after tricuspid valve repair
J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 498 - 503.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
D. D. Potter, T. M. Sundt III, K. J. Zehr, J. A. Dearani, R. C. Daly, C. J. Mullany, C. G.A. McGregor, F. J. Puga, H. V. Schaff, and T. A. Orszulak
Operative risk of reoperative aortic valve replacement
J. Thorac. Cardiovasc. Surg., January 1, 2005; 129(1): 94 - 103.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
J. S. Collins, A. Evangelista, C. A. Nienaber, E. Bossone, J. Fang, J. V. Cooper, D. E. Smith, P. T. O'Gara, T. Myrmel, D. Gilon, et al.
Differences in Clinical Presentation, Management, and Outcomes of Acute Type A Aortic Dissection in Patients With and Without Previous Cardiac Surgery
Circulation, September 14, 2004; 110(11_suppl_1): II-237 - II-242.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
D. D. Potter, T. M. Sundt III, K. J. Zehr, J. A. Dearani, R. C. Daly, C. J. Mullany, C. G. A. McGregor, F. J. Puga, H. V. Schaff, and T. A. Orszulak
Risk of repeat mitral valve replacement for failed mitral valve prostheses
Ann. Thorac. Surg., July 1, 2004; 78(1): 67 - 72.
[Abstract] [Full Text] [PDF]


Home page
Eur J Cardiothorac SurgHome page
W. R. E. Jamieson, L. H. Burr, R. T. Miyagishima, M. T. Janusz, G. J. Fradet, H. Ling, and S. V. Lichtenstein
Re-operation for bioprosthetic aortic structural failure - risk assessment
Eur J Cardiothorac Surg, December 1, 2003; 24(6): 873 - 878.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
W.R.E. Jamieson, L.H. Burr, R.T. Miyagishima, M.T. Janusz, G.J. Fradet, S.V. Lichtenstein, and H. Ling
Reoperation for Bioprosthetic Mitral Structural Failure: Risk Assessment
Circulation, September 9, 2003; 108(2011): II-98 - II-102.
[Abstract] [Full Text] [PDF]


Home page
Eur J Cardiothorac SurgHome page
M. J. Thompson, A. Behranwala, C. Campanella, W. S. Walker, and E. W. J. Cameron
Immediate and long-term results of mitral prosthetic replacement using a right thoracotomy beating heart technique
Eur J Cardiothorac Surg, July 1, 2003; 24(1): 47 - 51.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
K. Morishita, N. Kawaharada, J. Fukada, A. Yamada, T. Masaru, K. Kuwaki, and T. Abe
Three or more median sternotomies for patients with valve disease: role of computed tomography
Ann. Thorac. Surg., May 1, 2003; 75(5): 1476 - 1480.
[Abstract] [Full Text] [PDF]


Home page
Card Surg AdultHome page
J. G. Byrne, B. J. Phillips, and L. H. Cohn
Reoperative Valve Surgery
Card. Surg. Adult, January 1, 2003; 2(2003): 1047 - 1056.
[Full Text]


Home page
Eur J Cardiothorac SurgHome page
C. M. de Almeida Brandao, P. M. A. Pomerantzeff, L. R. Souza, F. Tarasoutchi, M. Grimberg, J. A. F. Ramires, and S. Almeida de Oliveira
Multivariate analysis of risk factors for hospital mortality in valvular reoperations for prosthetic valve dysfunction
Eur J Cardiothorac Surg, December 1, 2002; 22(6): 922 - 926.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
J. G. Byrne, A. N. Karavas, F. Filsoufi, T. Mihaljevic, L. Aklog, D. H. Adams, L. H. Cohn, and S. F. Aranki
Aortic valve surgery after previous coronary artery bypass grafting with functioning internal mammary artery grafts
Ann. Thorac. Surg., March 1, 2002; 73(3): 779 - 784.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
J. M. Jones, H. O'Kane, D. J. Gladstone, M. A.I. Sarsam, G. Campalani, S. W. MacGowan, J. Cleland, and G. W. Cran
Repeat heart valve surgery: Risk factors for operative mortality
J. Thorac. Cardiovasc. Surg., November 1, 2001; 122(5): 913 - 918.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
A. Weerasinghe, M.-B. Edwards, and K. M. Taylor
First Redo Heart Valve Replacement : A 10-Year Analysis
Circulation, February 9, 1999; 99(5): 655 - 658.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
C. W. Akins, M. J. Buckley, W. M. Daggett, A. D. Hilgenberg, G. J. Vlahakes, D. F. Torchiana, and J. C. Madsen
Risk of Reoperative Valve Replacement for Failed Mitral and Aortic Bioprostheses
Ann. Thorac. Surg., June 1, 1998; 65(6): 1545 - 1551.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
T. E. David, C. M. Feindel, S. Armstrong, and Z. Sun
RECONSTRUCTION OF THE MITRAL ANULUSA ten-year experience
J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1323 - 1332.
[Abstract] [Full Text]


Home page
J. Thorac. Cardiovasc. Surg.Home page
J. M. Piehler, E. H. Blackstone, K. R. Bailey, M. E. Sullivan, J. R. Pluth, N. S. Weiss, R. S. Brookmeyer, and J. G. Chandler
Reoperation on prosthetic heart valvesPatient-specific estimates of in-hospital events
J. Thorac. Cardiovasc. Surg., January 1, 1995; 109(1): 30 - 48.
[Abstract] [Full Text]


Home page
Ann. Thorac. Surg.Home page
L. H. Cohn, S. F. Aranki, R. J. Rizzo, D. H. Adams, K. A. Cogswell, N. M. Kinchla, G. S. Couper, and J. J. Collins Jr
Decrease in operative risk of reoperative valve surgery
Ann. Thorac. Surg., July 1, 1993; 56(1): 15 - 21.
[Abstract] [PDF]


Home page
Ann. Thorac. Surg.Home page
A. R. J. Cale, C. T. M. Sang, C. Campanella, and E. W. J. Cameron
Hufnagel revisited: A descending thoracic aortic valve to treat prosthetic valve insufficiency
Ann. Thorac. Surg., May 1, 1993; 55(5): 1218 - 1221.
[Abstract] [PDF]


Home page
Eur J Cardiothorac SurgHome page
M. J. Antunes
Techniques of valvular reoperation
Eur J Cardiothorac Surg, January 1, 1992; 6(Supplement_1): S54 - S58.
[Abstract] [PDF]


Home page
JAMAHome page
M. H. Eckman, J. R. Beshansky, I. Durand-Zaleski, H. J. Levine, and S. G. Pauker
Anticoagulation for Noncardiac Procedures in Patients With Prosthetic Heart Valves: Does Low Risk Mean High Cost?
JAMA, March 16, 1990; 263(11): 1513 - 1521.
[Abstract] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1986 by The Society of Thoracic Surgeons.