title: Long-term results of reoperative mitral valve surgery in patients with rheumatic disease.
abstract: BACKGROUND
  Reoperative (redo) mitral valve surgery is still a continuing challenge to surgeons. The aim of this study was to detect the factors that affect late mortality or morbidity after redo mitral valve surgery in patients with rheumatic disease.
  
  
  METHODS
  Between May 1983 and February 2003, 92 patients who underwent redo mitral valve surgery for rheumatic disease were enrolled. Risk factors influencing survival or cardiac events were investigated with univariate analysis and a Cox model.
  
  
  RESULTS
  Operative mortality rate was 4.2%. Kaplan-Meier actuarial analysis demonstrated an 84.7% 5-year, a 69.5% 10-year, and a 65.9% 15-year survival. Multivariate analysis demonstrated that age at surgery and preoperative New York Heart Association (NYHA) class were found to be independent predictors of late deaths, and that higher age, advanced NYHA class, and previous mitral valve replacement were independent predictors of cardiac events.
  
  
  CONCLUSIONS
  Redo mitral valve surgery can be achieved with low early mortality. However, long-term results of redo mitral surgery are not necessarily satisfactory in patients with preoperative advanced NYHA class or with a previous mechanical heart valve, and especially in 60 years or older age.
authors.affiliation: Department of Cardiovascular Surgery, Tenri Hospital, Tenri, Nara, Japan. kmatsuy@f3.dion.ne.jp
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsuyama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Takaaki
authors.initials: T
authors.lastname: Sugita
authors.forename: Junichiro
authors.initials: J
authors.lastname: Nishizawa
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Kawansihi
authors.forename: Kyokuu
authors.initials: K
authors.lastname: Uehara
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D015999:Multivariate Analysis; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012086:Reoperation; D012214:Rheumatic Heart Disease / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate