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Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement

Redo surgeries are becoming more common because of an increased rate of bioprosthesis implantation. We performed a retrospective study on patients who underwent redo replacement of an aortic and/or mitral bioprosthesis between 2005 and 2018 to evaluate intra-hospital mortality and morbidity. Univari...

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Autores principales: Giambuzzi, Ilaria, Bonalumi, Giorgia, Ballan, Giulia, Messi, Pietro, Bonomi, Alice, Maggiore, Analia, Esposito, Giampiero, Di Mauro, Michele, Alamanni, Francesco, Zanobini, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735554/
https://www.ncbi.nlm.nih.gov/pubmed/36498675
http://dx.doi.org/10.3390/jcm11237104
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author Giambuzzi, Ilaria
Bonalumi, Giorgia
Ballan, Giulia
Messi, Pietro
Bonomi, Alice
Maggiore, Analia
Esposito, Giampiero
Di Mauro, Michele
Alamanni, Francesco
Zanobini, Marco
author_facet Giambuzzi, Ilaria
Bonalumi, Giorgia
Ballan, Giulia
Messi, Pietro
Bonomi, Alice
Maggiore, Analia
Esposito, Giampiero
Di Mauro, Michele
Alamanni, Francesco
Zanobini, Marco
author_sort Giambuzzi, Ilaria
collection PubMed
description Redo surgeries are becoming more common because of an increased rate of bioprosthesis implantation. We performed a retrospective study on patients who underwent redo replacement of an aortic and/or mitral bioprosthesis between 2005 and 2018 to evaluate intra-hospital mortality and morbidity. Univariate analysis was performed on the propensity score variables to determine predictors of mortality. A total of 180 patients were enrolled in the study: Group A (replacement of aortic bioprosthesis) with 136 patients (75.56%) and group B (replacement of mitral bioprosthesis ± aortic bioprosthesis) with 44 patients (24.44%). NYHA class ≥ 3 and female sex were significantly more common in group B. Cardiopulmonary-bypass time and aortic cross-clamping time in group A and group B were, respectively, 154.95 ± 74.35 and 190.25 ± 77.44 (p = 0.0005) and 115.99 ± 53.54 and 144.91 ± 52.53 (p = 0.0004). Overall mortality was 8.89%. After propensity score adjustment, Group B was confirmed to have an increased risk of death (OR 3.32 CI 95% 1.02–10.88 p < 0.0001), gastrointestinal complications (OR 7.784 CI 95% 1.005–60.282 p < 0.0002) and pulmonary complications (OR 2.381 CI 95% 1.038–5.46 p < 0.0001). At the univariate analysis, endocarditis, cardiopulmonary-bypass and aortic cross clamping time, NYHA class ≥ 3 and urgency setting were significantly associated to death. Intra-hospital outcomes were acceptable regarding mortality and complications. Patients who need redo surgery on mitral bioprosthesis have an increased risk of post-operative pulmonary and gastrointestinal complications and mortality. Therefore the choice of mitral bioprosthesis at time of first surgery should be carefully evaluated.
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spelling pubmed-97355542022-12-11 Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement Giambuzzi, Ilaria Bonalumi, Giorgia Ballan, Giulia Messi, Pietro Bonomi, Alice Maggiore, Analia Esposito, Giampiero Di Mauro, Michele Alamanni, Francesco Zanobini, Marco J Clin Med Article Redo surgeries are becoming more common because of an increased rate of bioprosthesis implantation. We performed a retrospective study on patients who underwent redo replacement of an aortic and/or mitral bioprosthesis between 2005 and 2018 to evaluate intra-hospital mortality and morbidity. Univariate analysis was performed on the propensity score variables to determine predictors of mortality. A total of 180 patients were enrolled in the study: Group A (replacement of aortic bioprosthesis) with 136 patients (75.56%) and group B (replacement of mitral bioprosthesis ± aortic bioprosthesis) with 44 patients (24.44%). NYHA class ≥ 3 and female sex were significantly more common in group B. Cardiopulmonary-bypass time and aortic cross-clamping time in group A and group B were, respectively, 154.95 ± 74.35 and 190.25 ± 77.44 (p = 0.0005) and 115.99 ± 53.54 and 144.91 ± 52.53 (p = 0.0004). Overall mortality was 8.89%. After propensity score adjustment, Group B was confirmed to have an increased risk of death (OR 3.32 CI 95% 1.02–10.88 p < 0.0001), gastrointestinal complications (OR 7.784 CI 95% 1.005–60.282 p < 0.0002) and pulmonary complications (OR 2.381 CI 95% 1.038–5.46 p < 0.0001). At the univariate analysis, endocarditis, cardiopulmonary-bypass and aortic cross clamping time, NYHA class ≥ 3 and urgency setting were significantly associated to death. Intra-hospital outcomes were acceptable regarding mortality and complications. Patients who need redo surgery on mitral bioprosthesis have an increased risk of post-operative pulmonary and gastrointestinal complications and mortality. Therefore the choice of mitral bioprosthesis at time of first surgery should be carefully evaluated. MDPI 2022-11-30 /pmc/articles/PMC9735554/ /pubmed/36498675 http://dx.doi.org/10.3390/jcm11237104 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Giambuzzi, Ilaria
Bonalumi, Giorgia
Ballan, Giulia
Messi, Pietro
Bonomi, Alice
Maggiore, Analia
Esposito, Giampiero
Di Mauro, Michele
Alamanni, Francesco
Zanobini, Marco
Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement
title Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement
title_full Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement
title_fullStr Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement
title_full_unstemmed Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement
title_short Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement
title_sort looking back to look forward: what to expect in a redo surgery for a bioprosthesis replacement
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735554/
https://www.ncbi.nlm.nih.gov/pubmed/36498675
http://dx.doi.org/10.3390/jcm11237104
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