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Short‐ and long‐term outcomes following redo valvular surgery
Author(s) -
Fukunaga Naoto,
Sakata Ryuzo,
Koyama Tadaaki
Publication year - 2018
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.13534
Subject(s) - medicine , hazard ratio , odds ratio , surgery , log rank test , proportional hazards model , confidence interval
Aim We reviewed our experience in redo valvular surgery to evaluate trends in short‐ and long‐term outcomes. Methods We reviewed 414 patients (mean age, 62.8 ± 13.6 years) who underwent redo valvular surgery in the past 25 years. A total of 301 patients (54.2%) underwent first‐time redo valvular surgeries; 178 (32.1%) were second redos, 60 (10.8%) were third redos, and 16 were fourth redos (2.9%). The mean follow‐up period was 6.8 ± 6.3 years. Results Hospital mortality was 5.8%. New York Heart Association (NYHA) class III/IV ( P = 0.0007, odds ratio = 4.403) and hemodialysis ( P = 0.0383, odds ratio = 7.196) were risk factors for hospital death. Long‐term survival rates at 15 and 20 years were 64.7% ± 4.3% and 59.1% ± 5.0%, respectively. Predictors of late death were first time redo ( P = 0.0076, hazard ratio = 0.422) and age younger than 61 years ( P = 0.0005, hazard ratio = 0.229). There were significant differences in long‐term survival between NYHA classes I/II and III/IV (log‐rank test, P = 0.0419) and between the time from redo surgery (log‐rank test, P = 0.0189) and age (log‐rank test, P = 0.0001). Conclusions The hospital mortality rate for redo valve surgery has improved. Early referral for redo surgery can contribute to improving early and late outcomes.