Urgent redo surgery for prosthetic valve dysfunction carries a high mortality rate, particularly in patients with NYHA class III-IV or endocarditis, whereas scheduled reoperation in NYHA class I-II has a risk comparable to first-time surgery.
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NYHA III-IV and endocarditis predict higher early mortality after redo valve surgery; hypothesis-generating for optimized timing pending prospective validation.
Maciejewski et al. (2011) studied this question.
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