Key result
Redo valve surgery has become increasingly prevalent with improving clinical outcomes and acceptable mortality rates, while transcatheter valve-in-valve implantation emerges as a promising alternative.
Redo valve surgery has become safer with acceptable mortality rates, and transcatheter valve-in-valve implantation offers a promising future alternative for high-risk patients with bioprosthetic failure.
May support individualized choices for bioprosthetic failure; leaves open need for randomized comparisons of redo surgery versus valve-in-valve.
Surgeons are now facing the challenge of redo valve surgery because of the increasing number of elderly individuals in Japan. The incidence of bioprosthesis dysfunction has increased among the various surgical indications of redo valve surgery due to the preference of patients and a paradigm shift in prostheses from mechanical valves to bioprostheses. Previous studies reported that the clinical outcomes of reoperative valvular surgery have markedly improved due to the maneuver of myocardial protection, cardiopulmonary bypass strategies, and appropriate safer surgical approach. The general surgical outcomes of redo valve surgery have been reported as being similar to those of primary valve surgery; however, this is still controversial and has not yet been confirmed in some developed countries. Although the unique surgical technique of transcatheter valve-in-valve implantation for bioprosthetic dysfunction is promising, redo valve surgery may become more prevalent in the future. We here reviewed the current status of reoperative valve surgery and future perspectives including catheter-based surgical interventions.
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Furukawa et al. (2014) conducted a review in Valvular heart disease requiring redo surgery. Redo valve surgery was evaluated. Redo valve surgery has become increasingly prevalent with improving clinical outcomes and acceptable mortality rates, while transcatheter valve-in-valve implantation emerges as a promising alternative.
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