title: Outcome after redo-mitral valve replacement in adult patients: a 10-year single-centre experience.
abstract: The aim of this study was to investigate the overall outcome of adult patients undergoing redo-mitral valve replacement (redo-MVR) at our institution. Forty-nine patients (24 males) underwent redo-MVR with either bioprosthetic (n = 24) or mechanical valves (n = 25) between January 2000 and 2010. Median age of patients was 63 years (range 21-80 years), and the mean additive EuroSCORE was 12 ± 4. Median time to re-operation was 8.2 ± 6.6 years for first time redo-MVR and 6.4 ± 5.6 years for second-time redo-MVR. Indications included prosthetic endocarditis (n = 22), para-prosthetic leak (n = 12), structural valve degeneration (n = 8), prosthetic valve thrombosis (n = 6) and malignancy (n = 1). The mean follow-up was 47.5 ± 37.0 months (range 0.1-112.3 months). In-hospital mortality was 12% (n = 6). Mean hospital stay was 17 ± 11 days (range 8-50 days). Actuarial survival at 1 and 5 years was 81 ± 5% and 72 ± 6%, respectively. Three patients required re-intervention: two for prosthetic valve endocarditis and one for para-prosthetic leak. Multivariate analysis showed that overall survival was associated with the LVEF < 50% (P < 0.001), concomitant AVR (P < 0.001) and urgent surgery (P = 0.03).
authors.affiliation: Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, UK. hunaidvohra@yahoo.co.uk
authors.forename: Hunaid A
authors.initials: HA
authors.lastname: Vohra
authors.forename: Robert N
authors.initials: RN
authors.lastname: Whistance
authors.forename: Apostolos
authors.initials: A
authors.lastname: Roubelakis
authors.forename: Andrew
authors.initials: A
authors.lastname: Burton
authors.forename: Clifford W
authors.initials: CW
authors.lastname: Barlow
authors.forename: Geoffrey M K
authors.initials: GM
authors.lastname: Tsang
authors.forename: Steve A
authors.initials: SA
authors.lastname: Livesey
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Ohri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis; D004739:England; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D055815:Young Adult