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[Reintervention on valve prosthesis. 13 years' experience].
Minerva Cardioangiologica
|January 1, 1989
Summary
Reintervention on malfunctioning heart valves, mechanical or biological, can be successful if diagnosed early. Prompt diagnosis of valve prosthesis issues is key to improving patient outcomes and reducing operative mortality.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Clinical Medicine
Context:
- Between 1974 and 1986, 1584 valve prostheses (1231 mechanical, 353 biological) were implanted.
- 72 patients underwent 75 reinterventions for 80 malfunctioning prostheses (41 mechanical, 39 biological).
Purpose:
- To analyze the outcomes and mortality associated with reintervention on malfunctioning heart valve prostheses.
- To identify factors influencing operative mortality in valve prosthesis reintervention.
Summary:
- Mechanical prosthesis reinterventions were primarily due to detachment (61%) and endocarditis (19.5%).
- Biological prosthesis reinterventions were mainly due to wear (84.6%) and endocarditis (12.8%).
- Early diagnosis before symptoms improved outcomes; 30.7% of malfunctions were diagnosed pre-symptomatically.
Impact:
- Operative mortality was 17.3%, significantly higher in emergency cases (90.9%) and advanced functional classes (NYHA Class IV: 38.7%).
- Mortality was elevated for infectious endocarditis (38.4%) and mechanical prostheses (28.2%), though influenced by NYHA class.
- Timely diagnosis and intervention are crucial for favorable prognosis in valve prosthesis reintervention.