Previous Mechanical Valve Research Articles

Laparoscopic Resection of An Extensive Tuboovarian Abscess in A Mechanical Valve Replacement Woman

The case is a 44-year-old-female who presented with right lower abdominal pain without fever or leukocytosis. She had previous mechanical valve replacement with taking warfarin for last ten months from the diagnoses of infective endocarditis. The ultrasonography showed bilateral complex ovarian mass. At laparoscopy, the patient had a right tubo-ovarian abscess and a left mature teratoma with extensive adhesions to the rectum. A case illustrates an uncommon premenopausal age with right tuboovarian abscess and left mature teratoma. The laparoscopic surgery is an excellent benefit for quicker recovery time, smaller incisions, less post-operative pain, and especially of a few infections that will affect to underlying disease of the patient.

RF15 DOES RE-DO AORTIC VALVE SURGERY STILL HAVE A ROLE IN THE ERA OF TRANS-CATHETER AORTIC VALVE IMPLANTATION?

Abstract Background and aim: Re-do aortic valve replacements (AVR) have higher mortality and morbidity compared to first time AVR. Trans-catheter aortic valve implantation (TAVI) is an option for high-risk patients. The aim of the study is to present our experience with re-do aortic procedures. Method: Retrospective review of 80 patients (mean age 51.8 ± 18.73) who underwent re-do aortic valve procedures (2008–2017). 41 (51.2%) had re-do AVR and 39 (48.8%) re-do complex aortic surgery (28 root, 23 ascending and 6 hemiarch). Results: Mean Euroscore II was 8.3% (higher in the complex group 12 vs 5%). 19% of patients had a mechanical valve implanted as result of previous surgery. Indication for reoperation was: infective endocarditis in 19 (23.8%) (12 root abscess), bio-prosthesis degeneration in 10 (12.5%), mechanical valve dysfunction in 4 (5%), aortic aneurysm, pseudoaneurysm and dissection in 28 (35%), root/homograft degeneration in 22 (27.5%), patient-prosthesis mismatch in 3 (3.8%), paravalvular leak in 5 (6.2%), native valve disease in 20 (25%). 65.4% of patient had significant AR and 37,5% required concomitant procedures. IH mortality was 2.5% (0% re-do AVR vs 5.1% re-do complex). Conclusion: A large number of patients presented with contraindications for TAVI: age < 60 (61%), previous mechanical valve (18.8%), significant AR (65.4%), infective endocarditis (23.8%), need for complex aortic procedure (49%) or concomitant surgery (37.5%). The number of patients that would actally benefit from TAVI procedures is overestimated. Re-do aortic surgery remains the only treatment for such challenging cases and can be performed with acceptably low mortality and morbidity.