Heart valve surgery: an analysis of the causes and peri- and postoperative course]

From a total of 1,152 consecutive patients with heart valve replacement (1964-87) 108 patients (9.4%) had to be reoperated. Mechanical valves had to be replaced (n = 89) mainly because of perivalvular leakage followed by prosthetic stenosis and dysfunction. The lowest reoperation rate was found with Björk-Shiley prostheses (3.4%). Bioprostheses (reoperation rate 8.2%) had to be reoperated predominantly as a consequence of dysfunction. Ten years following implantation 30% of bioprostheses had to be replaced. Patients with reoperations demonstrated, in comparison to patients with singular valve replacement, no significant change in early mortality during the last 6 years (6.8% vs 5.4%). Furthermore, both patient groups revealed similar survival rates (10 years; 78% vs 76%) and improvement of life quality. However, non-lethal peri- and postoperative complication rates were higher in reoperated patients compared to patients with first valve replacement.