PMID- 25354746 OWN - NLM STAT- MEDLINE DCOM- 20160408 LR - 20150627 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 48 IP - 1 DP - 2015 Jul TI - The number of valves requiring surgery does not affect early and late survival in redo valvular surgery. PG - 123-8 LID - 10.1093/ejcts/ezu403 [doi] AB - OBJECTIVES: The purpose of this study was to determine whether the number of operated valves affects early and late outcomes in redo valvular surgery. METHODS: We analysed 328 consecutive patients who underwent a total of 431 redo valvular surgeries from January 1990 to December 2010. The mean age was 61.5 +/- 13.0 years. The main indication for redo surgery was structural valve deterioration (66.1%). We divided these patients into the redo single valvular surgery group (Group S, n = 175; 231 redo surgeries) and the redo multivalvular surgery group (Group M, n = 153; 201 redo surgeries). The mean follow-up period was 6.4 +/- 5.8 years. The follow-up rate for late survival was 98.3%. RESULTS: The hospital mortality rate was 6.5% in Group S and 7.0% in Group M (P = 0.85). Logistic regression analysis revealed that advanced age and New York Heart Association (NYHA) functional class III or IV were statistically significant independent risk factors for hospital mortality. Re-exploration for bleeding was more likely to occur in Group M than in Group S. The 5- and 10-year survival rates were 84.8 +/- 3.0 and 70.8 +/- 4.6% in Group S and 82.0 +/- 3.5 and 70.2 +/- 4.9% in Group M, respectively, with no statistical difference. Cox regression analysis revealed that advanced age, a left ventricular ejection fraction rate of <60% and redo surgery beyond the first redo were independent negative predictors of late mortality. NYHA functional class I or II was a statistically significant positive predictor of late survival. CONCLUSIONS: The number of valves requiring redo surgery does not negatively impact early or late survival. Mortality is not different whether one or multiple valves need to be tackled in a redo scenario. CI - (c) The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Fukunaga, Naoto AU - Fukunaga N AD - Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Hyogo, Japan naotowakimachi@hotmail.co.jp. FAU - Okada, Yukikatsu AU - Okada Y AD - Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Hyogo, Japan. FAU - Konishi, Yasunobu AU - Konishi Y AD - Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Hyogo, Japan. FAU - Murashita, Takashi AU - Murashita T AD - Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Hyogo, Japan. FAU - Koyama, Tadaaki AU - Koyama T AD - Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Chuo-ku, Kobe, Hyogo, Japan. LA - eng PT - Journal Article DEP - 20141029 PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Age Factors MH - Cardiac Valve Annuloplasty/adverse effects/methods/mortality/*statistics & numerical data MH - Female MH - Heart Valves/surgery MH - Humans MH - Male MH - Middle Aged MH - Proportional Hazards Models MH - Reoperation/adverse effects/*statistics & numerical data MH - Retrospective Studies MH - Risk Factors MH - Stroke Volume MH - Survival Analysis OTO - NOTNLM OT - Number of valves OT - Redo valvular surgery OT - Survival EDAT- 2014/10/31 06:00 MHDA- 2016/04/09 06:00 CRDT- 2014/10/31 06:00 PHST- 2014/05/24 00:00 [received] PHST- 2014/09/22 00:00 [accepted] PHST- 2014/10/31 06:00 [entrez] PHST- 2014/10/31 06:00 [pubmed] PHST- 2016/04/09 06:00 [medline] AID - ezu403 [pii] AID - 10.1093/ejcts/ezu403 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2015 Jul;48(1):123-8. doi: 10.1093/ejcts/ezu403. Epub 2014 Oct 29.