Original articleCardiovascularRepeat Valvular Operations: Bench Optimization of Conventional Surgery
Section snippets
Material and Methods
Hospital records of 316 consecutive HVR procedures were retrospectively analyzed. Patients were selected from the pool of 780 overall redo procedures performed at our institution in the 1997 through 2002 period, according to the following inclusion criteria: (1) use of full median sternotomy plus normothermic or hypothermic cardiopulmonary bypass; and (2) use of the same surgical strategy at first intervention.
All interventions were performed by the same surgical team. Patient characteristics
Results
Two hundred ninety patients who underwent a total of 316 HVR procedures were included in the present study. In the same period 1,508 isolated valvular procedures were performed in our unit. Baseline features of the population and comorbidity profile are presented in Table 1. Eleven patients (3.8%) had undergone a failed valve repair at first cardiac procedure. One hundred sixty-four patients (56%) underwent one HVR only, 76 patients (26%) underwent two HVRs, 48 patients (14%) underwent three
Comment
Redo interventions have been traditionally associated with high surgical risk and major challenges for the surgeon compared with a primary procedure. This could be partially ascribed to the frequently severe conditions leading to redo procedure. The majority of deaths in recent series are because of cardiac causes, especially myocardial failure, which reflects the severely compromised hemodynamic conditions of the patients presently undergoing HVRs. Specific technical features must be taken
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