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Postoperative outcomes of valve reoperation are associated with the number of previous cardiac operations

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Abstract

Objective

This study compared operative mortality and morbidity based on the number of previous cardiac operations to identify whether this was a risk factor for outcomes after valve reoperation.

Methods

Among valve surgery patients in the Japan Cardiovascular Surgery Database (2013‒2015), 4436 patients who underwent valve reoperation with a previous cardiac surgery were included. Patients were divided into three groups based on the number of previous cardiac operations (NPO1, NPO2, and NPO3+). Multivariable logistic regression analyses were conducted, adjusting for patient- and surgery-related factors to estimate the association of the NPO with the clinical outcomes of valve reoperation.

Results

Postoperative mortality was 8.6% in the NPO1, 11.2% in the NPO2, and 14.4% in the NPO3 + group, and the corresponding postoperative morbidity rates were 40.0, 46.2, and 59.2%, respectively. On multivariable logistic regression analysis, the odds of operative death were 1.36 (95% confidence interval [CI] 0.98‒1.87, p = 0.06) times higher for the NPO2 and 1.61 (95% CI 0.89‒2.90, p = 0.11) times higher for the NPO3+ group than for the NPO1 group. The odds ratios for postoperative complications were 1.31 (95% CI 1.08‒1.59, p < 0.01) for the NPO2 and 2.49 (95% CI 1.66‒3.74, p < 0.01) for the NPO3+ relative to the NPO1 group.

Conclusion

The number of previous cardiac operations is associated with postoperative outcomes in patients undergoing valve reoperations. Considering the risk of repeat cardiac surgery, we recommend careful selection of operative procedures to avoid reoperation in patients requiring primary valve surgery.

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Acknowledgements

We thank Dr. Takamoto for his support in the governance and management of the JCVSD.

IRB information: The study was approved by The Institutional Review Board of Gunma University Hospital (No. HS2020-235).

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Department of General Surgical Science, Gunma University, Showa-machi 3-39-22, Maebashi, Gunma, Japan

    Wataru Tatsuishi & Tomonobu Abe

  2. Department of Healthcare Quality Assessment, University of Tokyo Graduate School of Medicine, Tokyo, Japan

    Hiraku Kumamaru & Hiroaki Miyata

  3. Japan Cardiovascular Surgery Database Organization, Tokyo, Japan

    Wataru Tatsuishi, Kiyoharu Nakano & Noboru Motomura

Authors
  1. Wataru Tatsuishi
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  2. Hiraku Kumamaru
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  3. Tomonobu Abe
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  5. Hiroaki Miyata
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  6. Noboru Motomura
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Correspondence to Wataru Tatsuishi.

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Tatsuishi, W., Kumamaru, H., Abe, T. et al. Postoperative outcomes of valve reoperation are associated with the number of previous cardiac operations. Gen Thorac Cardiovasc Surg 70, 939–946 (2022). https://doi.org/10.1007/s11748-022-01828-0

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  • DOI: https://doi.org/10.1007/s11748-022-01828-0

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