الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
For the evaluation of risk factors associated with the development of and death caused by prosthetic or bioprosthetic mitral valve dysfunction, data were reviewed from Twenty-five patients who admitted to cardiology and cardiosurgical departments where they presented to mitral valve reoperation. Patients included in this study were classified into two groups according to postoperative survival and clinical status. We further classify group I into group Ia for those healthy survivors group Ib for survivors with morbidity and group II for the mortality.
The overall operative mortality was 20% with the higher mortality rate reported in cases of prosthetic valve thrombosis (60%) followed by prosthetic valve endocarditis (40 %) and no mortality reported after reoperation due to primary tissue valve failure.
Statistical analysis showed a significant better result for the patients undergoing elective reoperation with stable preoperative hemodynamic & patients with good preoperative left ventricular function.
The survivors (20 cases) were followed for a period of 3 months with no cases of late mortality were recorded.
The preoperative functional class markedly improved in the majority of survivors. A protocol for management of cases with prosthetic valve dysfunction is proposed for application.
The surgical risk of reoperation on heart valve prostheses can be reduced dramatically with no significant difference from that of primary operation if the intervention is not delayed with the best time for reoperation is before hemodynamic deterioration and in the presence of preserved left ventricular function. Also the aortic cross clamping time should be kept as short as possible with the reoperation better performed by the most competent surgeon to reduce the high operative mortality.