RE-REPLACEMENT FOR PROSTHETIC VALVE DYSFUNCTION - ANALYSIS OF LONG-TERM RESULTS AND RISK-FACTORS

Background. Prosthetic heart valve re-replacement still remains a chal lenging situation. Although some studies have examined the early resul ts, the long-term survival has not yet been well analyzed. The aim of this Study was to detect the factors that affect the long-term outcome of operation. Methods. Between April 1964 and September 1996, 231 pro sthetic valve re-replacements were performed including 16 cases of thi rd valve replacement, There were 100 men and 131 women with a mean age of 47 +/- 14 years. Results. The actuarial survival rate was 65% +/- 4% at 5 years and 41% +/- 7% at: 10 years. Multivariate analysis revea led that New York Heart Association class IV and left ventricular ejec tion fraction were found to be independent predictors of late death. C onclusions. Our study showed that advanced New York Heart Association functional class and lower left ventricular ejection fraction were fou nd to be independent predictors of late death. If operation is perform ed before patients reach such a deteriorated condition, long-term resu lts are excellent. (C) 1998 by The Society of Thoracic Surgeons.