PMID- 22858272
OWN - NLM
STAT- MEDLINE
DCOM- 20130129
LR  - 20121126
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 94
IP  - 6
DP  - 2012 Dec
TI  - Clinical outcomes of redo valvular operations: a 20-year experience.
PG  - 2011-6
LID - S0003-4975(12)01459-2 [pii]
LID - 10.1016/j.athoracsur.2012.06.045 [doi]
AB  - BACKGROUND: A higher operative mortality rate has been reported after redo 
      valvular procedures than after the primary operation. METHODS: Outcomes of 330 
      consecutive patients undergoing 433 redo valvular operations at our institute 
      during a 20-year period (January 1990 to December 2010) were reviewed 
      retrospectively. The mean follow-up was 6.4 years (range, 0.05 to 1.3 years). 
      Logistic regression analysis was used to identify factors associated with 
      hospital death. RESULTS: The overall hospital mortality rate was 6.7% (29 of 433 
      procedures). Logistic regression analysis identified only advanced New York Heart 
      Association (NYHA) class as an independent predictor of hospital death. Overall 
      survival at 5, 10, and 15 years was 83.6%+/-2.2%, 70.7%+/-3.4%, and 61.5%+/-4.5%, 
      respectively. The 5-, 10-, and 15-year survivals for the first redo vs more than 
      second redo groups were 86.5%+/-2.4% vs 74.7%+/-5.5%, 71.8%+/-3.9% vs 66.8%+/-6.6%, and 
      60.2%+/-5.7% vs 63.1%+/-7.2%, respectively (log-rank P=0.505). The 5- and 10-year 
      survivals for NYHA class I/II vs III/IV patients were 91.5%+/-2.1% vs 70.4%+/-4.5% 
      and 77.8%+/-4.1% vs 58.5%+/-5.6%, respectively (log-rank p<0.005). CONCLUSIONS: Redo 
      valvular operation in NYHA class III/IV patients is associated with high hospital 
      death and poor long-term survival. To achieve low hospital death and good 
      long-term survival, redo operations, including more than third redo operations, 
      should be performed in patients with lower NYHA class.
CI  - Copyright (c) 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Fukunaga, Naoto
AU  - Fukunaga N
AD  - Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, 
      Chuo-ku, Kobe, Japan. naotowakimachi@hotmail.co.jp
FAU - Okada, Yukikatsu
AU  - Okada Y
FAU - Konishi, Yasunobu
AU  - Konishi Y
FAU - Murashita, Takashi
AU  - Murashita T
FAU - Yuzaki, Mitsuru
AU  - Yuzaki M
FAU - Shomura, Yu
AU  - Shomura Y
FAU - Fujiwara, Hiroshi
AU  - Fujiwara H
FAU - Koyama, Tadaaki
AU  - Koyama T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20120802
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cause of Death/trends
MH  - Child
MH  - Female
MH  - *Forecasting
MH  - Heart Valve Diseases/mortality/*surgery
MH  - Heart Valve Prosthesis Implantation/*mortality
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Japan/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Young Adult
EDAT- 2012/08/04 06:00
MHDA- 2013/01/30 06:00
CRDT- 2012/08/04 06:00
PHST- 2012/04/26 00:00 [received]
PHST- 2012/06/20 00:00 [revised]
PHST- 2012/06/25 00:00 [accepted]
PHST- 2012/08/04 06:00 [entrez]
PHST- 2012/08/04 06:00 [pubmed]
PHST- 2013/01/30 06:00 [medline]
AID - S0003-4975(12)01459-2 [pii]
AID - 10.1016/j.athoracsur.2012.06.045 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2012 Dec;94(6):2011-6. doi: 10.1016/j.athoracsur.2012.06.045. 
      Epub 2012 Aug 2.