OBJECTIVE

To evaluate the results of redo heart valve replacement in patients with degeneration/thrombosis/infective endocarditis of bioprostheses.

MATERIAL AND METHODS

Redo heart valve replacement for degeneration/thrombosis/infective endocarditis of bioprosthesis was performed in 12 (0.9%) cases between 2017 to 2022 that accounted for 40% of redo surgeries (n=30). The sample included 6 men and 5 women, mean age was 51.2±13.2 years. Mitral valve replacement was performed in 6 patients, aortic valve replacement — 3 patients, tricuspid valve replacement — 3 patients (twice in one patient).

RESULTS

Mean time of cardiopulmonary bypass was 151.1±68.3 min, aortic clamping — 109.3±39.5 min. There was no in-hospital mortality. One patient with baseline infective endocarditis of mitral bioprosthesis had postoperative intoxication under systemic infectious process, cardiovascular and respiratory failure (nodal bradycardia), bilateral lower lobe pneumonia, postoperative delirium and encephalopathy. In the second patient, postoperative period was complicated by sternomediastinitis, pneumonia and pleural empyema.

CONCLUSION

The feasibility of heart valve replacement with bioprostheses should be comprehensively assessed in young people due to high risk of redo cardiac surgery. In our opinion, implantation of these prostheses should be regulated by clear clinical indications (contraindications to anticoagulation, high risk of hemorrhagic complications, etc.), short life expectancy (up to 5 years) or informed patient desire.