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Date Published: 12/04/2022
Abstract Views: 390
Views PDF: 259
DOI: https://doi.org/10.47972/vjcts.v37i.757
Issue
Vol. 37
Section
Research Article
How to Cite
Nghia, D. V. ., Huu, N. C., & Thuy, N. T. (2022). Results of reoperative mitral valve replacement at cardiovascular center - E hospital. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 37, 34-45. https://doi.org/10.47972/vjcts.v37i.757

Results of reoperative mitral valve replacement at cardiovascular center - E hospital

Doan Van Nghia, Nguyen Cong Huu, Nguyen Tran Thuy

Main Article Content

Abstract

Overview: Mitral valve (MV) disease is the most common valvular disease; surgery is the definitive treatment when it is no longer possible for conservative treatment. The number of patients undergoing MV replacement surgery is increasing and life expectancy is increasing, leading to an inevitable increase in the number of patients having to undergo reoperative MV replacement. Redo MV replacement remains a challenge. The study aimed to evaluate the results of redo-mitral valve replacement surgery.


           Method: This is a retrospective, descriptive study of   patients who underwent reoperative mitral valve replacement at cardiovascular center – E hospital, from January 2015 to December 2019.


           Results: Thirty seven patients (24 females) underwent redo-MVR with either bioprosthetic (n = 18) or mechanical valves (n = 18). Median age of patients was 53 years (range 30–78 years), and the mean additive EuroSCORE was 8.15%. Median time to re-operation was 5.37± 2.78 years for first time redo-MVR and 3 years for second-time redo-MVR. Indications included prosthetic endocarditis (n = 9), para-prosthetic leak (n = 1), structural valve degeneration (n = 12), prosthetic valve thrombosis (n = 15). In-hospital mortality was 5.41%. Mean hospital stay was 27.54± 15.93 days. Actuarial survival at 1 and 5 years was 81 ± 5% and 72 ± 6%, respectively. Multivariate analysis showed that mortality was associated with Euroscore and infectious complications.


           Conclusion: Mitral valve replacement surgery is safe and effective in improving clinical symptoms and laboratory parameters. Regular postoperative monitoring is required to reduce the risk of reoperation due to prosthetic valve thrombosis. Good infection prevention and management could reduce mortality and length of hospital stay.

Article Details

Keywords

Reoperation, Mitral valve, E hospital

References

1. Đặng Văn Phước, Châu Ngọc Hoa, Tạ Thị Thanh Hương. Hẹp van hai lá. Hà Nội: Bệnh học Nội khoa, NXB Y Học; 2012. 1 p.
2. Đặng Hanh Đệ. Điều trị ngoại khoa trong bệnh van tim do thấp. Hà Nội: Thấp tim và bệnh tim do thấp, NXB Y học, Hà Nội; 2002. 288 – 314 p.
3. Phan Kim Phương. Phẫu thuật điều trị bệnh van tim. Hà Nội: NXB Y học, Hà Nội; 1999. 381-6 p.
4. Nguyễn Hữu Ước. Kết quả ban đầu của phẫu thuật tạo hình van hai lá tại Bệnh viện Việt Đức. Tạp chí tim mạch học Việt Nam. 2005;27:60 – 5.
5. Nguyễn Văn Phan. Nghiên cứu áp dụng phương pháp sửa van của Carpentier trong bệnh hở van 2 lá. Đại học Y dược Thành phố Hồ Chí Minh: Luận án tiến sĩ y học; 2006.
6. Jamieson W, Burr L, Miyagishima R, Janusz M, Fradet G, Lichtenstein S, et al. Reoperation for bioprosthetic mitral structural failure: risk assessment. Circulation. 2003;108(10_suppl_1):II-98-II-102.
7. Vohra HA, Whistance RN, Roubelakis A, Burton A, Barlow CW, Tsang GM, et al. Outcome after redo-mitral valve replacement in adult patients: a 10-year single-centre experience. Interact Cardiovasc Thorac Surg. 2012;14(5):575-9.
8. Mehaffey HJ, Hawkins RB, Schubert S, Fonner C, Yarboro LT, Quader M, et al. Contemporary outcomes in reoperative mitral valve surgery. Heart. 2018;104(8):652-6.
9. Cohn LH, Aranki SF, Rizzo RJ, Adams DH, Cogswell KA, Kinchla NM, et al. Decrease in operative risk of reoperative valve surgery. The Annals of thoracic surgery. 1993;56(1):15-21.
10. Abdelgawad A, Salem A, Elshemy A. Hospital outcome and predictors of operative mortality in redo MVR adult population. Cardiovascular Disorders and Medicine. 2017;3(1).
11. Fukunaga N, Miyakoshi C, Sakata R, Koyama T. Impact of valve type on outcomes after redo mitral valve replacement in patients aged 50 to 69 years. Interact Cardiovasc Thorac Surg. 2018;27(3):322-7.
12. Baldwin ACW, Tolis G, Jr. Tissue Valve Degeneration and Mechanical Valve Failure. Curr Treat Options Cardiovasc Med. 2019;21(7):33.
13. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2017;70(2):252-89.
14. Nguyễn Xuân Thành. Nghiên cứu đặc điểm lâm sàng cận lâm sàng và kết quả phẫu thuật thay van hai lá có huyết khối nhĩ trái tại Bệnh viện Việt Đức: Trường Đại học Y Hà Nội; 2010.
15. Đặng Hanh Sơn. Nghiên cứu đánh giá kết quả phẫu thuật thay van hai lá bằng van nhân tạo cơ học Sorin tại Bệnh viện Tim Hà Nội: Học viện quân y; 2011.
16. Nguyễn Duy Thắng. Nghiên cứu đặc điểm lâm sàng, cận lâmsàng và kết quả phẫu thuật thay van hai lá cơ học tại bệnh viện hữu nghị Việt Đức: Đại học Y Hà Nội; 2011.
17. Moskowitz G, Hong KN, Giustino G, Gillinov AM, Ailawadi G, DeRose JJ, et al. Incidence and risk factors for permanent pacemaker implantation following mitral or aortic valve surgery. Journal of the American College of Cardiology. 2019;74(21):2607-20.
18. Akay TH, Gultekin B, Ozkan S, Aslim E, Uguz E, Sezgin A, et al. Mitral Valve Replacements in Redo Patients with Previous Mitral Valve Procedures: Mid‐Term Results and Risk Factors for Survival. Journal of cardiac surgery. 2008;23(5):415-21.
19. Jones JM, O'Kane H, Gladstone DJ, Sarsam MA, Campalani G, MacGowan SW, et al. Repeat heart valve surgery: risk factors for operative mortality. The Journal of Thoracic and Cardiovascular Surgery. 2001;122(5):913-8.