title: Redo surgery risk in patients with cardiac prosthetic valve dysfunction.
abstract: BACKGROUND
  The aim of the study was to analyse the risk factors of early and late mortality in patients undergoing the first reoperation for prosthetic valve dysfunction.
  
  
  METHODS
  A retrospective observational study was performed in 194 consecutive patients (M = 75, F = 119; mean age 53.2 ±11 years) with a mechanical prosthetic valve (n = 103 cases; 53%) or bioprosthesis (91; 47%). Univariate and multivariate Cox statistical analysis was performed to determine risk factors of early and late mortality.
  
  
  RESULTS
  The overall early mortality was 18.6%: 31.4% in patients with symptoms of NYHA functional class III-IV and 3.4% in pts in NYHA class I-II. Multivariate analysis identified symptoms of NYHA class III-IV and endocarditis as independent predictors of early mortality. The overall late mortality (> 30 days) was 8.2% (0.62% year/patient). Multivariate analysis identified age at the time of reoperation as a strong independent predictor of late mortality.
  
  
  CONCLUSIONS
  Reoperation in patients with prosthetic valves, performed urgently, especially in patients with symptoms of NYHA class III-IV or in the case of endocarditis, bears a high mortality rate. Risk of planned reoperation, mostly in patients with symptoms of NYHA class I-II, does not differ from the risk of the first operation.
authors.affiliation: Department of Cardiology, 1st Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Maciejewski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Piestrzeniewicz
authors.forename: Agata
authors.initials: A
authors.lastname: Bielecka-Dąbrowa
authors.forename: Monika
authors.initials: M
authors.lastname: Piechowiak
authors.forename: Ryszard
authors.initials: R
authors.lastname: Jaszewski