PMID- 17143707
OWN - NLM
STAT- MEDLINE
DCOM- 20070817
LR  - 20181113
IS  - 0910-8327 (Print)
IS  - 0910-8327 (Linking)
VI  - 21
IP  - 6
DP  - 2006 Nov
TI  - Risk factors for short- and long-term survival in patients undergoing 
      re-replacement due to prosthetic valve dysfunction.
PG  - 339-43
AB  - The purpose of this study was to investigate the effect of preoperative, 
      intraoperative, and postoperative variables on early, mid-, and long-term outcome 
      of re-replacement of prosthetic valves. Between February 1989 and January 2004, 
      192 patients who were treated for prosthetic valve dysfunction were analyzed 
      retrospectively using a computer-based databank system. Prosthetic valve 
      re-replacements were performed, including 164 cases of second, 10 cases of third, 
      and 2 cases of fourth valve re-replacement. The number of re-replacements 
      amounted to 6.1% (n = 176) of total valvular surgery. There were 90 male patients 
      (46.8%) and the mean age was 61.6 +/- 8.3 years. Median follow-up time was 7.8 
      years. Hospital mortality was 11.7% (n = 14). Low ejection fraction (EF), 
      advanced New York Heart Association (NYHA) functional class, prosthetic valve 
      endocarditis, and pulmonary edema were found to be predictors of early mortality. 
      The 1-, 5-, and 10-year actuarial survival rates were 92% +/- 3%, 78% +/- 3%, and 
      45% +/- 2%, respectively. Multivariate analysis revealed that NYHA class IV, low 
      EF, prosthetic valve endocarditis, advanced age, left ventricular end-systolic 
      diameter (LVESD) >50 mm, and double valve re-replacement were independent 
      predictors of late mortality. In our study NYHA class IV, low EF, prosthetic 
      valve endocarditis, and LVESD >50 mm were found to be risk factors for both 
      hospital mortality and long-term survival. In addition, pulmonary edema, advanced 
      age, and double valve replacement were also risk factors over the long term. 
      Aggressive treatment of endocarditis and early re-replacement before aggravation 
      of left ventricle function will improve the results.
FAU - Oz, Bilgehan Savas
AU  - Oz BS
AD  - Department of Cardiovascular Surgery, Gulhane Military Medical Academy, Gulhane 
      Askeri Tip Akademisi, Kalp Damar Cerrahisi, Etlik, Ankara 06018, Turkey.
FAU - Iyem, Hikmet
AU  - Iyem H
FAU - Akay, Hakki Tankut
AU  - Akay HT
FAU - Bolcal, Cengiz
AU  - Bolcal C
FAU - Yokusoglu, Mehmet
AU  - Yokusoglu M
FAU - Kuralay, Erkan
AU  - Kuralay E
FAU - Demirkilic, Ufuk
AU  - Demirkilic U
FAU - Tatar, Harun
AU  - Tatar H
LA  - eng
PT  - Journal Article
DEP - 20061127
PL  - Japan
TA  - Heart Vessels
JT  - Heart and vessels
JID - 8511258
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Female
MH  - Heart Valve Diseases/complications/*mortality/surgery
MH  - Heart Valve Prosthesis/*adverse effects
MH  - Heart Valve Prosthesis Implantation/*adverse effects
MH  - Hospital Mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Postoperative Complications/mortality
MH  - Prosthesis-Related Infections/mortality
MH  - Reoperation/*statistics & numerical data
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2006/12/05 09:00
MHDA- 2007/08/19 09:00
CRDT- 2006/12/05 09:00
PHST- 2005/06/16 00:00 [received]
PHST- 2006/01/21 00:00 [accepted]
PHST- 2006/12/05 09:00 [pubmed]
PHST- 2007/08/19 09:00 [medline]
PHST- 2006/12/05 09:00 [entrez]
AID - 10.1007/s00380-006-0906-4 [doi]
PST - ppublish
SO  - Heart Vessels. 2006 Nov;21(6):339-43. doi: 10.1007/s00380-006-0906-4. Epub 2006 
      Nov 27.