Abstract
Background Various complications lead to reoperation in patients who undergo prosthetic valve replacement where inflammatory process could be involved. The goals of this study were to identify risk factors that correlate with reoperation in patients with prosthetic heart valves and to investigate the relationship between reoperation and inflammatory gene polymorphisms.Results The study included 228 patients from the EwhA–Severance Treatment Group of Warfarin. Single nucleotide polymorphisms of c-reactive protein (CRP), interferon-gamma, interleukin 1 beta, interleukin 6, interleukin 10, transforming growth factor beta 1, and tumor necrosis factor genes were genotyped by means of SNaPshot and TaqMan assays. Thirty-nine patients (17.1 %) underwent more than one heart valve operation. A threefold increased risk for heart valve reoperation was evident in homozygous variant-type (TT) carriers as compared with ancestral allele carriers of CRP rs1205. Logistic regression analysis revealed that CRP rs1205 (OR 2.68, 95 % CI 1.22–5.90, p = 0.014), valve position (mitral valve OR 2.80, 95 % CI 1.01–7.80, p = 0.048; tricuspid valve OR 9.24, 95 % CI 2.46–34.70, p = 0.001; reference: aortic valve) and time after first operation (OR 1.13, 95 % CI 1.06–1.20, p < 0.001) affected the risk of reoperation.ConclusionsInflammatory gene polymorphisms could be a possible marker of risk for reoperation in patients with prosthetic heart valve surgery.
Highlights
Various complications lead to reoperation in patients who undergo prosthetic valve replacement where inflammatory process could be involved
Valve positions were a statistically significant predictor of reoperation, and tricuspid valve surgery posed the highest risk for reoperation
There were no significant differences between patients with and those without reoperation in terms of age, age at operation, percentage of time in the therapeutic range on warfarin, and comorbidities
Summary
Various complications lead to reoperation in patients who undergo prosthetic valve replacement where inflammatory process could be involved. The goals of this study were to identify risk factors that correlate with reoperation in patients with prosthetic heart valves and to investigate the relationship between reoperation and inflammatory gene polymorphisms. Approximately 280,000 prosthetic heart valves are implanted worldwide every year. Prosthetic heart valves may require one or more reoperations. About 10 % of the patients with an aortic or mitral mechanical valve usually undergo. Various complications lead to reoperation in patients who undergo prosthetic valve replacement, the most frequent being obstructive valve thrombosis and pannus development (Rizzoli et al 1999). Valve thrombosis occurs when a thrombus is attached to or is near a prosthetic heart valve, obstructing blood flow or causing valve regurgitation. Other reasons for reoperation include failure of previous valve repair, paravalvular leakage, infective or non-infective endocarditis, and prosthetic valve
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