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November 1979

Aortic and Mitral Prosthetic Valve ReoperationsEarly and Late Results

Author Affiliations

From the Department of Cardiovascular Surgery, Stanford (Calif) University School of Medicine.

Arch Surg. 1979;114(11):1279-1283. doi:10.1001/archsurg.1979.01370350081008

• A total of 232 valvular reoperations (123 mitral valve reoperations [RMVR] and 109 aortic valve reoperations [RAVR] were performed in 194 patients with previously implanted prosthetic valves. Early mortality was 10% (12/123) for the RMVR subgroup and 14% (15/109) for the RAVR subgroup (P=NS). Late mortality was 16% (18/111) for the RMVR subgroup and 25% (23/94) for the RAVR subgroup (P=NS). Patients with prosthetic endocarditis or prosthetic stenosis constituted higher-risk subpopulations. Principal determinants of both operative mortality and late attrition were preoperative cardiac functional status and the nature of the pathology mandating valve rereplacement. Early prosthetic valve rereplacement is advocated to correct hemodynamic abnormalities before advanced ventricular decompensation ensues, especially when prosthetic valvular endocarditis or prosthetic stenosis exists.

(Arch Surg 114:1279-1283, 1979)