title: Redo valvular surgery in elderly patients aged > 75 years.
abstract: OBJECTIVE
  Very few data exist regarding the clinical outcome of redo valvular surgery in patients aged > 75 years.
  
  
  METHODS
  A retrospective analysis was conducted of 42 consecutive patients (mean age 78.3 years) who had undergone redo valvular surgery between January 1991 and December 2010, and who had been followed up for a mean of 2.5 years. Factors associated with early outcomes were analyzed using logistic regression analysis, while predictors of late death and valve-related events were identified using Cox regression analysis.
  
  
  RESULTS
  The overall hospital mortality rate of redo procedures was 17%. Multivariate logistic regression analysis showed that prolonged ventilator support (OR 1.007; 95% CI: 1.000-1.014; p < 0.0464) was an independent risk factor for hospital mortality. Overall survival rates at one and three years were 78.3 +/- 6.8% and 67.1 +/- 8.6%, respectively. Multivariate Cox regression analysis of survival revealed that age (HR 1.399; 95% CI: 1.044-1.875; p < 0.0238) and prolonged ventilator support (HR 1.004; 95% CI: 1.001-1.006; p < 0.0051) were negative predictors of mid-term survival. Rates of freedom for valve-related events at one and three years were 77.4 +/- 7.5% and 60.2 +/- 9.6%, respectively. An absence of peripheral artery disease protected against valve-related events (HR 0.045; 95% CI: 0.004-0.44; p < 0.0080).
  
  
  CONCLUSIONS
  Early and late outcomes for elderly patients who had undergone redo valvular surgery were relatively poor and satisfactory, respectively. Hence, an optimal referral for redo surgery is important to achieve better outcomes.
authors: Naoto
authors: N
authors: Fukunaga
authors: Yukikatsu
authors: Y
authors: Okada
authors: Yasunobu
authors: Y
authors: Konishi
authors: Takashi
authors: T
authors: Murashita
authors: Hideo
authors: H
authors: Kanemitsu
authors: Tadaaki
authors: T
authors: Koyama
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012086:Reoperation; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome