Risque opératoire des réopérations pour dysfonction de bioprothèses aortiques et mitrales.

Objective: The risk of reoperation for aortic or mitral bioprosthesis dysfunction is not well established. It takes a major place in the choice of the fi rst implanted valve. The goal of this study was to determine the morbi-mortality associated with those reoperations and to assess the validity of EuroSCORE in those patients. Methods: From 1990 to 2006, 156 patients were reoperated for aortic bioprosthesis dysfunction (AVR group) and 282 patients reoperated for mitral bioprosthesis dysfunction (MVR group). Mean age was 61 years in both groups. Results: Operative mortality was 3,8% in AVR group and 7,4% in MVR group. Risk factor for mortality were a reoperation in emergency in AVR group, diabetes mellitus, chronic obstructive lung disease, systolic pulmonary hypertension, NYHA stage III/IV for MVR group. EuroSCORE overestimated this risk in AVR group and was well correlated with reoperative risk in MVR group. Conclusion: The risk of reoperation for aortic bioprosthesis dysfunction is low and this type of valve can be used even if a reoperation can be predictable. In mitral position, this risk is higher, and a reoperation is acceptable only for people without comorbidities or advanced cardiopathy.