Boston - American Association for Thoracic Surgery

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTSRESULTS: The mortality for reoperative AVR patients significantly decreased overtime (I: 15% [6/39], II: 15% [8/53], III: 2% [2/99], p = 0.005) and was equivalent toprimary AVR in the current era (3.5% [19/542] vs. 2.0% [2/99], p = 0.65). Majorcomplication rates also significantly decreased over time in reoperative AVRpatients (I: 15% [6/39], II: 17% [9/53], III: 5% [5/99], p = 0.04) and was similar topatients undergoing primary AVR (12% [23/191] vs. 15% [215/1412], p = 0.30) in thecurrent era. Importantly, patients had more comorbidities including dyslipidemia(26% [10/39], 42% [22/53], 77% [76/99], P < 0.0001), coronary artery disease(31% [12/39], 49% [26/53], 84% [83/99], P < 0.0001) and hypertension (39% [15/39], 53% [28/53], 69% [68/99], P = 0.003) over time while other preoperative riskfactors were similar. In reoperative AVR patients, there were no differences in outcomebased on primary operation. Specifically, mortality at reoperation was similarfollowing primary CABG + AVR (19% [3/16]), CABG (6% [5/88]) and AVR (9%[6/70], p = 0.18). Major complication rates were also not dependent on primaryoperation (CABG + AVR: 25% [4/16], CABG: 15% [13/88], and AVR: 9% [6/70],p = 0.21).CONCLUSION: Reoperative AVR now carries similar morbidity and mortality asprimary AVR. The risk of reoperation is not affected by the primary operation.82