Related Experiment Videos
[Repeated valvular replacements. Apropos of 64 cases]
C Boesch1, P Vernant, J P Cachera
1Service de Cardiologie, hôpital Henri-Mondor, Créteil.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|October 1, 1987
Summary
Prosthetic valve reoperations occurred in 7.6% of patients, often due to desinsertion, particularly endocarditis. Early valve degeneration was noted in children, and thromboembolic events in mechanical mitral valve recipients.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Infectious Diseases
Context:
- Analysis of 1011 prosthetic valve implantations across 833 operations.
- Identified 64 reoperations in 44 patients, representing a 7.6% incidence rate.
- Investigated reasons for reoperation and associated complications.
Purpose:
- To determine the incidence and causes of reoperations following prosthetic valve implantation.
- To assess complications such as desinsertion, endocarditis, and thromboembolic events.
- To evaluate outcomes, including mortality, in patients requiring reoperation.
Summary:
- Desinsertion was the primary indication for reoperation in nearly 50% of cases, with incidence increasing with repeat surgeries.
- Bacterial endocarditis was a significant cause of desinsertion (40%).
- Bioprosthetic valve degeneration was rapid in pediatric patients, and mechanical mitral valves were linked to thromboembolic accidents.
Impact:
- Peri-operative mortality due to left ventricular dysfunction was 9%.
- Reoperation for endocarditis on a dislodged valve carried a high mortality risk.
- Highlights the critical importance of surveillance and prevention strategies for bacterial endocarditis in prosthetic valve recipients.