title: Mid-term results of the valve-on-valve technique for bioprosthetic failure.
abstract: OBJECTIVE
  Redo operations for bioprosthesis malfunction can sometimes be technically very demanding and cardiac structures may be damaged. Excising only the leaflets of the damaged bioprosthesis and leaving the old ring in situ on which the 'new' mechanical valve is sutured can, in very selected cases, represent a solution.
  
  
  METHODS
  Twenty-two patients were operated on, with the valve-on-valve technique, from September 1991 through December 1992. There were three operative deaths.
  
  
  RESULTS
  The surviving 19 patients were followed-up from 83 to 98 months (mean 90.5 months.). There were two late deaths. The patients were examined clinically and with transthoracic and transesophageal echocardiograms. All patients were in good condition and the echocardiographic examinations showed no clinically important gradients across the prostheses.
  
  
  CONCLUSIONS
  The valve-on-valve technique, in certain difficult situations, can give successful mid-term results.
authors.affiliation: Departement of Cardiac Surgery, Medical School, University Federico II, Via S. Pansini 5, 80131, Naples, Italy. pstassa@tin.it
authors.forename: P
authors.initials: P
authors.lastname: Stassano
authors.forename: A
authors.initials: A
authors.lastname: Musumeci
authors.forename: M A
authors.initials: MA
authors.lastname: Losi
authors.forename: C
authors.initials: C
authors.lastname: Gagliardi
authors.forename: N
authors.initials: N
authors.lastname: Spampinato
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome