MedStar Authors catalog › Details for: Clinical Outcomes of Mitral Valve Reoperations in the United States: An Analysis of the Society of Thoracic Surgeons National Database.
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Clinical Outcomes of Mitral Valve Reoperations in the United States: An Analysis of the Society of Thoracic Surgeons National Database.

by Thourani, Vinod H.
Citation: Annals of Thoracic Surgery. 2018 Oct 23.Journal: The Annals of thoracic surgery.Published: ; 2018ISSN: 0003-4975.Full author list: Kilic A; Acker MA; Gleason TG; Sultan I; Vemulapalli S; Thibault D; Ailawadi G; Badhwar V; Thourani V; Kilic A.UI/PMID: 30365952.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.athoracsur.2018.08.083 (Click here) Abbreviated citation: Ann Thorac Surg. 2018 Oct 23.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007.Abstract: BACKGROUND: This study evaluated outcomes of reoperative mitral valve surgery (MVS) in the United States.Abstract: METHODS: Adults undergoing isolated MVS with prior open-heart surgery in the Society of Thoracic Surgeons (STS) National Database between July 2011 and September 2016 were included. Urgent or emergent cases as well as all indications and etiologies for MVS were included. Primary outcomes were operative mortality and morbidity. Multivariable models were used for risk-adjustment incorporating variables from the STS Valve Risk Model as well as type of prior operation and reoperative approach.Abstract: RESULTS: 17,195 patients underwent isolated reoperative MVS at 962 centers. The STS predicted risk of mortality (STS-PROM) was 8.0%, with 20% having an STS-PROM of >10%. Prior cardiac operations included previous mitral valve surgery (61%), coronary artery bypass (39%), aortic valve surgery (18%), and tricuspid valve surgery (6%). Operative mortality for the overall study cohort was 6.6% and postoperative stroke occurred in 2.4%. Observed-to-expected mortality for the overall cohort was 0.82. The strongest independent predictors of operative mortality included salvage operation, preoperative dialysis dependence, congestive heart failure, recent myocardial infarction, and active endocarditis. Prior aortic valve replacement was associated with increased mortality risk whereas prior mitral valve surgery reduced mortality risk. Surgical approach did not impact mortality. For elective, non-endocarditis cases with prior mitral surgery, the operative mortality was 3.4%.Abstract: CONCLUSIONS: Despite a high-risk patient profile, surgical outcomes of reoperative MVS were acceptable, particularly in elective cases with prior mitral valve surgery and without endocarditis.Abstract: Copyright (c) 2018. Published by Elsevier Inc.

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