Determinants factors of hospital morbidity and mortality after reintervention of valve replacement

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Jalel Ziadi
Rim Lakhdhar
Insaf Medeb
Dorsaf belgaid
Mourad Hakim
Habiba Drissa
Adel Khayati

Abstract

Background: Valve surgery involves valvular substitutes that expose to different types of complications that can lead to re subsequent interventions.
aim : was to identify the predictors factors of in-hospital morbidity and mortality of re interventions after valve replacement .
methods : Retrospective study of 73 consecutive patients who underwent a re valve replacement between 1985 and 2010 in the Cardiovascular Surgical department of La Rabta hospital .
results: The average age at further surgery was 44 years ( 15-80 years) and sex ratio of 0.87 . The average time between interventions was 10 years (3 days -33 years). Different etiologies were found prosthesis thrombosis (36.9% ). The overall hospital mortality was 36.9 % , 11 intraoperative deaths and 16 immediate postoperative deaths.
Conclusion : The iterative intervention of valve replacement surgery is increasingly mastered by the surgical team . According to this study , the prognosis depends mainly on the patient preoperatively state, the cause of further surgery and its mode of occurrence .

Keywords:

Valvular surgery , further surgery , morbidity, mortality .

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References

  1. Beurtheret S, Gariboldi V, Feier H et al. Short-term results of repeat valve replacement: a predictive factor analysis. J Heart Valve Dis. 2010;19:326-32.
  2. Toker ME, Eren E, Guler M et al.Second and third cardiac valve reoperations: factors influencing death and long-term survival. x Heart Inst J. 2009;36:557-62.
  3. LytleB, Cosgrove D, Taylor P et al. Reoperations for valve surgery: preoperative mortality and determinants of risk for 1000 patients.Ann Thorac Surg 1986; 42: 632-643
  4. Acar J, Michel PL, varenne O et al. Surgical treatment of infection endocarditis. Eur Heart J 1995;16B: 94-98
  5. Lytle B, Priest B, Taylor P et al.Surgical treatment of prosthetic valve endocarditis.J Thorac Cardiovasc Surg 1996;111:198-210
  6. Akins C, Buckley M, Dagett W et Al. Risk of reoperative valve replacement for failed mitral and aortic bioprothesis. Ann Thorac Surg 1998; 65: 1545-1552
  7. Piehler J, Balckstone E, Bailey K et al. Reoperation on prosthetic heart valves. J Thorac Cardioasc Surg 1995;109:30
  8. Leora B.and al. Reoperative Valve Surgery in the Elderly:Predictors of Risk and Long-Term Survival. Ann Thorac Surg 2010; 90:1195-201
  9. Leontyev S, Borger MA, Modi P, Lehmann S, Seeburger J. Redo aortic valvesurgery: Influence of prostheticvalve endocarditis on outcomes. J Thorac Cardiovasc Surg. 2011;1:99-105.
  10. Fedoruk LM, Jamieson WR, Ling H, Macnab JS, Germann E, Karim SS. Predictors of recurrence and reoperation for prostheticvalve endocarditis after valve replacement surgeryfor native valve endocarditis.J Thorac Cardiovasc Surg. 2009; 137(2):326-33.
  11. Fang G, Keyst T, Gentry L, Harris A. prosthetic valve endocarditis resulting from nosocomial bacteremia. Ann Intern Med 1993; 199: 560-567