[Reoperations on prosthetic heart valves: an analysis of 64 cases]

During the period of Fabruary 1988 to May 1996, 64 reoperations were performed for prosthetic valve malfunction. Degeneration of bioprosthesis occurred in 46 patients, failure of mechanical prosthesis in 9, and periprosthetic leakage without evidence of infection in 9. In accordance with the status of cardiac function, 9 patients with acute dysfunction of mechanical prosthesis received emergency operations, and the remaining 55 patients with bioprosthetic valve failure or periprosthetic leakage received selective operation. There were 8 early deaths with a overall hsopital mortality rate of 12.5%. Three of the deaths occurred among the 55 selective procedures for a mortality of 5.3% and 3 of the deaths occurred among the 9 emergence procedures for mortality of 33.3%. The 56 long-term survivors were followed up from 3 months to 7 years (mean 2.1 years). There were 3 late deaths (5.3%). Forty-eight patients have been living more than 1 year. Their cardiac function after reoperation was class I (42 patients), class II (5), and class III (1). The timing of reoperation and surgical technique were discussed.