Repeat open intracardiac operation. Analysis of fifty operations.

Between December, 1972, and February, 1976, 50 open-heart operations were performed on 44 patients who had previously had open cardiotomies. Reasons for reoperation were failure of biological tissue valves (15 cases), failure of mechanical valves (12 cases), paraprosthetic reguritation (nine cases), recurrent or incompletely corrected congenital malformations (eight cases), prosthetic endocarditis (two cases), misdiagnoses (two cases), and miscellaneous causes (two cases). Operations performed included 20 aortic valve replacements, 10 mitral valve replacements, seven double valve replacements, five repairs of paraprosthetic leaks, one tricuspid valve replacement, and seven procedures for congenital defects. There were two deaths within 30 days of operation (operative mortality rate of 4 percent) and six deaths between 7 weeks and 3 years after operation. Postoperative complications were slightly more frequent than in patients undergoing similar operations for the first time. The late functional result was good in the majority (73%) of survivors.