Long-term results of reoperative mitral valve surgery in patients with rheumatic disease.
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.
Matsuyama
Katsuhiko
K
Department of Cardiovascular Surgery, Tenri Hospital, Tenri, Nara, Japan. kmatsuy@f3.dion.ne.jp
Matsumoto
Masahiko
M
Sugita
Takaaki
T
Nishizawa
Junichiro
J
Kawansihi
Yujiro
Y
Uehara
Kyokuu
K
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