Cardiac Valve Reoperations: Analysis of Operative Risk Factors in 154 Patients
Cesare Beghi MD, Giuseppe De Cicco MD, Francesco Nicolini MD, Luca Ballore MD, Claudio Reverberi MD, Tiziano Gherli MD

The study aim was to evaluate the operative risks of reoperation on heart valve prostheses. Between January 1985 and December 2000, 154 patients (79 males, 75 females; mean age 61.2 ± 9.5 years) underwent cardiac valve reoperation. Total replacements numbered 161 (64 aortic, 96 mitral and one tricuspid). There were 18 repairs, and one patient underwent prosthesis thrombectomy (mechanical valve). Overall operative mortality was 8.4% (n = 13); emergency operation (p <0.002), advanced NYHA class (p <0.026), indication for reoperation (p <0.026), gender (p <0.016) and number of previous reoperations (p = 0.05) were independent determinants. In conclusion, correct planning of reoperation timing reduces operative risks due to NYHA, and to urgent-emergency procedures. The high operative risk of prosthesis thrombosis is a deterrent to implanting mechanical prostheses in patients with disorders of hemostasis.