Outcome after redo-mitral valve replacement in adult patients: a 10-year single-centre experience

• Published in: Interactive cardiovascular and thoracic surgery 2012-05, Vol.14 (5), p.575-579
• Main Authors: Vohra, Hunaid A., Whistance, Robert N., Roubelakis, Apostolos, Burton, Andrew, Barlow, Clifford W., Tsang, Geoffrey M.K., Livesey, Steve A., Ohri, Sunil K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Aortic Valve - surgery; Bioprosthesis; England; Female; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - instrumentation; Heart Valve Prosthesis Implantation - mortality; Hospital Mortality; Humans; Institutional Reports; Kaplan-Meier Estimate; Male; Middle Aged; Mitral Valve - surgery; Multivariate Analysis; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Complications - surgery; Proportional Hazards Models; Prosthesis Design; Reoperation; Retrospective Studies; Risk Assessment; Risk Factors; Stroke Volume; Time Factors; Treatment Outcome; Ventricular Function, Left; Young Adult
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivs005

The aim of this study was to investigate the overall outcome of adult patients undergoing redo-mitral valve replacement (redo-MVR) at our institution. Forty-nine patients (24 males) underwent redo-MVR with either bioprosthetic (n = 24) or mechanical valves (n = 25) between January 2000 and 2010. Median age of patients was 63 years (range 21-80 years), and the mean additive EuroSCORE was 12 ± 4. Median time to re-operation was 8.2 ± 6.6 years for first time redo-MVR and 6.4 ± 5.6 years for second-time redo-MVR. Indications included prosthetic endocarditis (n = 22), para-prosthetic leak (n = 12), structural valve degeneration (n = 8), prosthetic valve thrombosis (n = 6) and malignancy (n = 1). The mean follow-up was 47.5 ± 37.0 months (range 0.1-112.3 months). In-hospital mortality was 12% (n = 6). Mean hospital stay was 17 ± 11 days (range 8-50 days). Actuarial survival at 1 and 5 years was 81 ± 5% and 72 ± 6%, respectively. Three patients required re-intervention: two for prosthetic valve endocarditis and one for para-prosthetic leak. Multivariate analysis showed that overall survival was associated with the LVEF < 50% (P < 0.001), concomitant AVR (P < 0.001) and urgent surgery (P = 0.03).