Short- and mid-term outcomes after redo surgical valve replacement

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Outcomes Research

Background:

• Limited long-term follow-up data exists for redo surgical valve replacement (SVR).
• Prognostic data is crucial for decision-making and identifying low-risk patients for redo SVR.
• This study evaluates short- and mid-term outcomes of first and second redo SVR.

Purpose of the Study:

• To assess the short- and mid-term outcomes of patients undergoing first and second redo SVR.
• To identify predictors of mortality, major adverse events (MAE), and prosthetic valve thrombosis, embolic events, and major hemorrhage (TEH).

Main Methods:

• 118 consecutive patients with first or second redo SVR were analyzed.
• Median follow-up was 69 months.
• Bayesian model averaging was used to analyze clinical, intraoperative, and laboratory data for mortality, MAE, and TEH predictors.

Main Results:

• 30-day mortality was 9.3%; chronic kidney disease predicted early mortality.
• One-year and five-year survival rates were 86% and 76%, respectively.
• Predictors for mortality included dyslipidemia, prior bleeding, CKD, stroke, and valve leakage; predictors for TEH included diabetes, sex, PCI history, and functional capacity; predictors for MAE included hypertension and functional class.

Conclusions:

• Redo SVR demonstrated acceptable short- and mid-term outcomes, especially in lower-risk patients.
• Several independent predictors for adverse outcomes were identified.
• Findings can inform clinical decision-making and patient management for redo SVR procedures.