Repeat open-heart operations: Review of sixty-eight operations

Between January, 1973 and September, 1982, 68 repeat open-heart operations were performed on 62 patients who had had previous open-heart surgery. Indications for reoperation were recurrent or incompletely corrected congenital malformations (21 cases), paraprosthetic leak (11 cases), thrombosed prosthesis (8 cases), incomplete diagnosis (5 cases), prosthetic endocarditis (4 cases), structural failure of mechanical valve (4 cases), homograft failure (2 cases), operative damage to aortic valve (1 case), and failure of conservative surgery (1 case). In eleven patients the natural disease process progressed after the first operation requiring further open-heart procedures. Operations performed included 24 procedures for congenital defects, 22 for mitral valve replacement, 17 for aortic valve replacement, 2 for repair of paraprosthetic leak, and 3 for mis-cellaneous operations. There were ten deaths within 30 days of operation. Postoperative complications were slightly more frequent than in patients under-going similar operations for the first time. The late functional results were good in the majority of survivors.