Dysfunction of primary aortic valve prosthesis--allogenic versus mechanical--preoperative differences.
OBJECTIVE
Comparison of preoperative characteristics between patients reoperated for allogenic and mechanical aortic valve prosthesis dysfunction.


METHODS
Retrospective data analysis of 47 patients reoperated for aortic valve prosthesis dysfunction at Department of Cardiovascular Surgery and Transplantology in Kraków, Poland between January 1999 and December 2002.


RESULTS
In analyzed group 27 patients were operated for dysfunction of allogenic valve (Gr. A), 20 pts for mechanical valve (Gr. B). Group A: 21 males (M), 6 females (F), age 23-68 years old (av. 47.10 +/- 11.71); Group B: 18 M, 2 F, age 38-77 (av. 54.73 +/- 11.03), p<0.05. Time between operations in group A was 69-258 months (av. 164.34 +/- 66.02) months and in group B 0.5-348 months (av. 77.27 +/- 98.29) p<0.01. In group A, 5 pts and in group B, 7 pts were in NYHA group IV preoperatively. Echocardiography revealed that diastolic left ventricular dimension (LVDD) was larger in group A: av. 6.7 cm and 5.36 cm in group B, p<0.05. 2 pts from group A and 7 pts from group B were operated urgently (p<0.05), including 3 pts with aortic dissection. Definite infective endocarditis was diagnosed in 6 pts from group A and 11 pts from group B, p<0.05. In group A, 1 patient was urgently operated for infective endocarditis with vegetations, he died due to multiorgan failure. In group B, 6 pts died including all 3 with aortic dissection.


CONCLUSIONS
Patients reoperated for allogenic aortic valve prosthesis dysfunction are: younger, reoperated after a much longer period of time with slower valve dysfunction progress (larger LVDD), most frequently reoperated electively, less frequently with endocarditis as the cause of valve dysfunction than in patients reoperated for mechanical aortic valve dysfunction.
Sadowski
Jerzy
J
Klinika Chirurgii Serca, Naczyń i Transplantologii, Instytut Kardiologii, Collegium Medicum Uniwersytet Jagielloński, Krakowski Szpital Specjalistyczny im. Jana Pawła II. kardiochir@szpitaljp2.krakow.pl
Kapelak
Bogusław
B
Wróbel
Krzysztof
K
Piatek
Jacek
J
Drwiła
Rafał
R
Rudziński
Paweł
P
Wierzbicki
Karol
K
Sobczyk
Dorota
D
Grudzień
Grzegorz
G
Marek
Grzegorz
G
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000473:pathology / Q000637:transplantation*; D001705:Bioprosthesis / Q000009:adverse effects*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging