[Risk of second and third reoperation on prosthetic heart valves]

As the volume of heart valve replacements increases, more patients are undergoing repeated operations. There are many reasons for reoperations that include incomplete or imperfectly executed primary operation, infection on valve prostheses, valve related complications. Repeated operations have their own specific technical problems, and from them depends mortality and complications rate. At Vilnius University Heart Surgery Clinic from 1967 we performed 6200 heart valve replacement operations. At the same time we performed 428 reoperations for 394 patients. Two reoperations were performed for 28 patients and 3 reoperations for 3 patients (65 reoperations for 31 patient). Main course of reoperation - sepsis and periprosthetic leaks (50%). Half of patients at the time of last reoperation were in functional class V (NYHA). Mortality rate after second reoperation was 28%, after third reoperation all three patients died. Main course of operative mortality - sepsis, heart failure, hemorrhage.