Results of reoperative mitral valve replacement at cardiovascular center - E hospital

Abstract

Overview: Mitral valve (MV) disease is the most common valvular disease; surgery is the definitive treatment when it is no longer possible for conservative treatment. The number of patients undergoing MV replacement surgery is increasing and life expectancy is increasing, leading to an inevitable increase in the number of patients having to undergo reoperative MV replacement. Redo MV replacement remains a challenge. The study aimed to evaluate the results of redo-mitral valve replacement surgery.
 Method: This is a retrospective, descriptive study of patients who underwent reoperative mitral valve replacement at cardiovascular center – E hospital, from January 2015 to December 2019.
 Results: Thirty seven patients (24 females) underwent redo-MVR with either bioprosthetic (n = 18) or mechanical valves (n = 18). Median age of patients was 53 years (range 30–78 years), and the mean additive EuroSCORE was 8.15%. Median time to re-operation was 5.37± 2.78 years for first time redo-MVR and 3 years for second-time redo-MVR. Indications included prosthetic endocarditis (n = 9), para-prosthetic leak (n = 1), structural valve degeneration (n = 12), prosthetic valve thrombosis (n = 15). In-hospital mortality was 5.41%. Mean hospital stay was 27.54± 15.93 days. Actuarial survival at 1 and 5 years was 81 ± 5% and 72 ± 6%, respectively. Multivariate analysis showed that mortality was associated with Euroscore and infectious complications.
 Conclusion: Mitral valve replacement surgery is safe and effective in improving clinical symptoms and laboratory parameters. Regular postoperative monitoring is required to reduce the risk of reoperation due to prosthetic valve thrombosis. Good infection prevention and management could reduce mortality and length of hospital stay.