Risk factors and management of XXXX after mitral valve repair.

@entity1 @entity64 @entity63 @entity1252 @entity260 @entity281 @entity583 @entity340 @entity884
BACKGROUND AND AIMS OF THE STUDY: The authors' nine-year experience with @entity1 requiring mitral valve reoperations for @entity884 after previous mitral valve repair is reported. METHODS: Between June 1991 and June 2000, 1,275 mitral valve repairs were performed at the authors' institution. During this time, nine @entity1 with prior mitral valve repair presented with mitral valve (non-recurrent) @entity884 requiring surgical correction. Etiology at the initial mitral valve repair was @entity63 in four @entity1 (44%), floppy valve in one @entity1 (11%), @entity1252 in one (11%), irradiation-induced degeneration in one (11%), and @entity884 in two cases (22%). Median @entity1 age was 61 years (range: 36-81 years). Median ejection fraction was 50% (range: 23-70%), and seven @entity1 (78%) presented urgently or emergently. The median time interval between the two procedures was 8.6 months (range: 28 days to 14.3 years). RESULTS: Certain risk factors were identified in these @entity1 , including @entity281 , prosthetic implants in the bloodstream, and subsequent invasive procedures. The mitral valve was re-repaired in one @entity1 (11%), while eight @entity1 (89%) required valve replacement. All required excision of the ring. Hospital mortality was 11% (n = 1). @entity260 included perioperative @entity583 in two cases (25%), low cardiac output in two (25%), and prolonged ventilatory support in four (50%). There was no perioperative @entity64 , and no late recurrence of @entity884 . CONCLUSION: The study findings suggest that the incidence of (non-recurrent) @entity884 after mitral valve repair requiring surgical intervention is infrequent. Attempts at re-repair may be successful only in selected @entity1 . Reoperation was accomplished with acceptable morbidity and mortality, and often required mitral valve replacement; however, late results indicated the absence of @entity340 .
