Clinical Analysis Of 102 Cases In Reoperation Or Multiple Surgery Of Valvular Heart Disease

Objective: To summarize surgical experiences and explore risk factors of patients undergoing repeated heart valve surgery. Methods: Clinical records of 102 consecutive patients who underwent repeated heart valve surgery from January 2011 to December 2015 in Fujian Provincial Hospital cardiovascular surgical department. There were 34(33.3%)male patients and 68(66.7%) female patients with their age of12~72(48.3±10.9) years old. Following variables were collected: general information,preoperative morbidity, heart function, indications and surgical strategies of repeated heart valve surgery, postoperative complications, which were compared with those clinical data of patients who underwent their first heart valve surgery during the same period. SPSS was used to make analysis on the differences of clinical information of patients undergoing repeated heart valve surgery. Results: The main reasons for repeated heart valve surgery were mitral valve restenosis after closed mitral commissurotomy and secondary other valvular diseases after their first heart valve surgery. 3 patients died during perioperative period, the case fatality rate was 2.94%. The main reasons of in-hospital death included malignant arrhythmia, low cardiac output syndrome(LCOS)and multiple organ dysfunction syndrome(MODS). Compared with patients undergoing their first heart valve surgery,patients who underwent repeated heart valve surgery were more likely to have a younger average age, a higher proportion of female,and they were more likely to have atrial fibrillation. They also had more postoperative morbidities such as malignant arrhythmia, acute renal failure, hepatic insufficiency, central nervous system damage, sepsis, lung infections, acute respiratory distress syndrome(ARDS),poor surgical wound healing. Conclusion: Valve surgery patients usually need reoperation in cases of severe valvular abnormality. Repeated heart valve surgery is a difficult surgical procedure with comparatively higher risks. The peri-operative risk and postoperative complication rate were higher.