Management of patients requiring a reintervention of the heart valve: Experience of the cardiology department of University Hospital Center of Oran

Abstract

Background - Valvular heart disease still common despite improved health conditions that have reduced the rheumatic fever incidence. Surgical and interventional indications have expanded and today we operate at early stages, sometimes even an asymptomatic stage. Valvular reoperation is required in 15% of cases during the evolution of an operated valve disease. The aim of our study is to determine the frequency of valvular reoperations and identify the main indications of these reinterventions. Methods - This is a retrospective study included 45 patients who were admitted to the cardiology department of University Hospital center of Oran, from January 2011 to July 2013 and who had previously operated valvular disease requiring another surgical valvular reoperation. Results - The mean age is 41 years. 73% of patients are women and 27% are men. 95% of patients are symptomatic (NYHA dyspnea stage II). Reinterventions affected the mitral valve in 69% of cases, the aortic valve in 37% cases and the tricuspid valve in 35%. We reporte the importance of neglected aortic and tricuspid regurgitation during the first intervention (31% and 62% respectively). The average time between the two interventions, all types combined, is 21 years. Conclusion - Cardiac reoperations may occur during the course of valvular heart disease. A good initial cardiac evaluation before surgery on the mitral or aortic valve is essential to overcome the problem of neglected valvular disease reoperation.

Keywords

• Valvular reintervention
• Prothesis dysfunction
• endocarditis
• neglected valvular disease