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Left ventricular function and valvular reoperations

J Turina1, M Turina

  • 1Department of Internal Medicine, University Hospital, Zurich, Switzerland.

The Journal of Heart Valve Disease
|October 1, 1995
PubMed
Summary
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Cardiac valve reoperations in 1,120 patients showed a 7% operative mortality and acceptable long-term survival. Despite increasing patient complexity, outcomes remained favorable, supporting timely reintervention for significant valve disease.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Disease
  • Medical Interventions

Background:

  • Reoperation for cardiac valve disease presents unique challenges.
  • Long-term outcomes of valvular reinterventions require ongoing evaluation.

Purpose of the Study:

  • To assess the outcomes of adult and adolescent patients undergoing reoperation for aortic, mitral, or both valves.
  • To evaluate trends in patient characteristics and procedural complexity over time.
  • To identify factors influencing operative mortality and long-term survival after valve reintervention.

Main Methods:

  • Retrospective analysis of 1,120 patients undergoing valve reintervention between 1961 and 1994.
  • Evaluation of operative mortality, survival rates, and patient demographics.

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  • Assessment of left ventricular systolic function in a subset of patients.

    • Main Results:

    • Operative mortality was 7%, with 20-year survival at 52%.
    • Patient age, incidence of endocarditis, concomitant coronary surgery, and repeat interventions increased over time.
    • Higher mortality observed in patients over 65, with concomitant coronary surgery, or ascending aorta interventions.
    • Impaired ejection fraction did not significantly impact late outcomes for most valve lesions.

    Conclusions:

    • Valvular reoperations can be performed with acceptable operative risk and long-term outcomes.
    • Timely reintervention is recommended for hemodynamically significant valvular or prosthetic lesions, irrespective of left ventricular function.