PMID- 9423105
OWN - NLM
STAT- MEDLINE
DCOM- 19980130
LR  - 20061115
IS  - 0389-7893 (Print)
IS  - 0389-7893 (Linking)
VI  - 14
IP  - 4
DP  - 1994 Aug
TI  - [Reoperations for prosthetic heart valves: operation techniques and determinant 
      factors of operative mortality].
PG  - 301-5
AB  - Between 1982 and 1993, 93 patients underwent reoperation for prosthetic heart 
      valves at our hospital. There were 41 male and 52 female patients who ranged in 
      age 2 to 70 years with a mean age of 47 years. Twenty-four patients were in New 
      York Heart Association (NYHA) functional class II, 52 in class III, and 17 in 
      class IV, preoperatively. The indications of reoperative valve surgery were 
      primary tissue failure of a bioprosthesis in 57 patients, valve thrombosis in 10, 
      nonstructural valve dysfunction in 12, cloth wear of a ball valve in 5, 
      endocarditis in 5, and others in 4. In reoperation, the heart was not mobilized 
      from the pericardium to prevent tearing the heart and great vessels. All 
      operative procedures were performed through the pericardium which adhered tightly 
      to the heart. Adequate myocardial protection was obtained without total 
      dissection of the heart with cold crystalloid cardioplegic solution and topical 
      cooling which was accomplished by filling the left pleural space with cold 
      saline. The operative mortality was 7 of the 93 patients (7.5%), falling from 
      4/36 (11.1%) in 1982 through 1987 to 3/57 (5.3%) in 1988 through 1993. Advanced 
      New York Heart Association functional class, prolonged cardiopulmonary bypass and 
      aortic cross clamping times were the determinant factors of operative mortality. 
      These results suggest that reoperation for dysfunctioning prosthetic heart valves 
      should be performed before deterioration of the hemodynamic condition of the 
      patient.
FAU - Aoyagi, S
AU  - Aoyagi S
AD  - Second Department of Surgery, Kurume University School of Medicine.
FAU - Ohishi, K
AU  - Ohishi K
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Rinsho Kyobu Geka
JT  - Rinsho kyobu geka = Japanese annals of thoracic surgery
JID - 8211641
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Heart Valve Diseases/surgery
MH  - Heart Valve Prosthesis Implantation/*methods/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Prosthesis Failure
MH  - Reoperation
EDAT- 1994/08/01 00:00
MHDA- 1998/01/10 00:01
CRDT- 1994/08/01 00:00
PHST- 1994/08/01 00:00 [pubmed]
PHST- 1998/01/10 00:01 [medline]
PHST- 1994/08/01 00:00 [entrez]
PST - ppublish
SO  - Rinsho Kyobu Geka. 1994 Aug;14(4):301-5.