Key result
Emergency redo mitral valve replacement is linked to higher hospital mortality versus elective admission.
Why the study?
Redo mitral valve replacement is increasingly common with decreasing perioperative risk, but short-term outcomes comparing emergency versus elective cases need investigation.
Does emergency redo mitral valve replacement compared to elective surgery affect hospital mortality in adult patients with previous mitral valve replacement?
Cohort (n=40)
Does emergency redo mitral valve replacement compared to elective surgery affect hospital mortality in adult patients with previous mitral valve replacement?
Emergency redo mitral valve replacement is associated with higher hospital mortality compared to elective procedures, likely driven by worse preoperative clinical status.
Urges caution for emergency redo mitral valve replacement; leaves open whether preoperative optimization mitigates risk in observational data.
Background: With advances in medical therapy and life expectancy, reoperation to replace dysfunctional mechanical heart valve prosthesis is an increasingly common procedure and there have been gradual decreases in perioperative risk for redo valve surgery over the past 2 decades Aim of the work: The aim of this study was to investigate the overall outcome of adult patients undergoing redo-mitral valve replacement (redo-MVR).Patients and Methods: forty cases had previous mitral valve replacement were admitted for redo mitral valve replacement.They were divided into two groups: Group (A): (Twenty cases) were admitted as emergency cases from the ER.Group (B): (Twenty cases) were admitted from out patient clinic as elective cases.Results:The hospital mortality was (20%).There was no effect regarding age, sex, cardiac rhythm, number of previous operations, type of the previous prosthesis, and interval from last implantation.Taking in consideration that mortality was higher with emergency group (15%).Conclusion: pre operative parameters of morbidity and mortality that showed higher incidence in emergency group were:NYHA functional class, LVEDD , LVESD dimensions, Redo cardiac surgery, Infective endocarditis, left ventricular dysfunction EF less than 35.
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Emad et al. (2017) conducted a cohort in Dysfunctional mechanical heart valve prosthesis requiring redo-mitral valve replacement (n=40). Emergency admission for redo-mitral valve replacement vs. Elective admission for redo-mitral valve replacement was evaluated on Hospital mortality. Emergency admission for redo-mitral valve replacement was associated with higher hospital mortality compared to elective admission, with an overall cohort hospital mortality of 20%.
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