[Reintervention on valve prosthesis. 13 years' experience]. / Reintervento su protesi valvolare. Tredici anni di esperienza.

1584 valve prosthesis implants [1231 mechanical (MP) and 353 biological (BP)] were carried out personally between March 1974 and December 1986. Over the same period, 72 patients, 36 m and 26 f, average age 48, underwent 75 reintervention (RI) on 80 malfunctioning prostheses 41 MP, 39 BP, 41 in mitral position, 28 aortic, 1 tricuspid). The reasons for RI in the MP were: partial detachment (61%), infectious endocarditis (19.5%), mechanical dysfunction (14.7%), thrombosis (2.4%), wear (2.4%) and in the BP: wear (84.6%), infectious endocarditis (12.8%), partial detachment (2.6%). The malfunction was diagnosed before the onset of subjective symptomatology in 30.7% of patients. Operative mortality (OM) was 17.3% related to the functional class (II = 0%; III = 2.7%; IV = 38.7%) and to whether or not the intervention was an emergency or of choice (90.9% and 4.7% respectively). Mortality was higher in patients operated on for infectious endocarditis (38.4%) and in wearers of MP (28.2% vs. 5.7% BP); however this difference is largely attributable to a difference in NYHA class. It is concluded that reintervention on valvular prosthesis may have a very prognosis provided diagnosis of malfunction is quick enough to avoid excessive functional deterioration.