title: Clinical features of third open-heart valve surgery at the same valve position.
abstract: OBJECTIVE
  Recently, there has been an increase in case of repeated open-heart valve surgery and the clinical results of the second surgery are only slightly worse than those of the first surgery. However, clinical results of the third open-heart valve surgery at the same position are rarely reported. Clinical features of third open-heart valve surgery at the same position are discussed in this study.
  
  
  METHODS
  Between 1995 and 2004, 16 patients underwent third open-heart valve surgery at the same valve position under cardiopulmonary bypass. The average age of the 16 patients, 12 females and 4 males, was 56 +/- 15 years. Clinical features of the 16 cases were retrospectively analyzed.
  
  
  RESULTS
  Mechanical valve nonstructural dysfunction was the most common valve malady, followed by bioprosthetic valve dysfunction. The duration of surgery from skin incision to establishment of the cardiopulmonary bypass was 94 +/- 42 minutes. Myocardial ischemia time was 137 +/- 38 minutes and extracorporeal circulation time was 212 +/- 82 minutes. Early mortality was seen in 1 patient (6.25%) and late mortality was seen in 1 patient.
  
  
  CONCLUSIONS
  Mechanical valve nonstructural valve dysfunction leads to repeated valve surgery. The clinical results of the third open-heart valve surgery at the same valve position are acceptable, and the mid-term survival is excellent.
authors.affiliation: Division of Cardiovascular Surgery, Jichi Medical School, 3311-1 Yakushiji, Minami-kawachi, Tochigi 329-0498, Japan.
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Ohki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Misawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saito
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Konishi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kaminishi
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Sakano
authors.forename: Kei
authors.initials: K
authors.lastname: Aizawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Taguchi
authors.forename: Takako
authors.initials: T
authors.lastname: Shinohara
mesh_terms: D000328:Adult; D000368:Aged; D001705:Bioprosthesis; D002315:Cardiopulmonary Bypass / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome