PMID- 10456406
OWN - NLM
STAT- MEDLINE
DCOM- 19990930
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 16
IP  - 1
DP  - 1999 Jul
TI  - Aortic valve replacement in the octogenarians: perioperative outcome and clinical 
      follow-up.
PG  - 68-73
AB  - OBJECTIVES: To determine long-term results of aortic valve replacement (AVR) in 
      patients 80 years old or older, and assess the factors influencing perioperative 
      outcome. METHODS: Data were reviewed on 83 consecutive octogenarians, undergoing 
      aortic valve replacement between 1992 and 1997. There were 66 women and 17 men 
      (mean age: 82.8 years). Fifty-seven patients (69%) were in New York Heart 
      Association (NYHA) class III-IV and six had previous myocardial infarction. Three 
      patients had previous percutaneous aortic valvuloplasty. There were 19 urgent 
      procedures (23%). Coronary artery bypass grafting (CABG) was performed on 21 
      patients (25%). Possible influence of preoperative and operative variables on 
      early and late mortality was performed with univariate and multivariate 
      statistical analysis, and survival was estimated with the Kaplan-Meier method. 
      RESULTS: Operative mortality was 13% (9% for AVR, 24% for AVR-CABG). 
      Postoperative complications were respiratory failure in 19 patients, atrial 
      fibrillation in 19, hemodialysis in four, myocardial infarction in four and 
      stroke in two patients. Five patients required pacemaker insertion for permanent 
      atrioventricular block. Median hospital stay and intensive care unit stay were 
      19.8 +/- 12.2 days and 7.9 +/- 3.4 days, respectively. Multivariate predictors of 
      hospital death (P < 0.05) were percutaneous aortic valvuloplasty, NYHA class IV, 
      and urgent procedure. Mean follow-up was 26.5 months. Survival at 1, 2, and 5 
      years was 98.5 +/- 1.4% (63 patients at risk), 93.4 +/- 3.2% (47 patients at 
      risk), and 78.2 +/- 6.9% (six patients at risk), respectively. Preoperative 
      myocardial infarction and urgent procedure were independent predictors of late 
      death. At most recent follow-up, 91% were angina free and 81% were in class I-II. 
      CONCLUSIONS: Aortic valve replacement in octogenarians can be performed with 
      acceptable mortality. These results stress the importance of early operation on 
      elderly patients with aortic valve disease. Both long-term survival and 
      functional recovery are excellent.
FAU - Kolh, P
AU  - Kolh P
AD  - Cardiothoracic Surgery Department, University Hospital of Liege, Belgium. 
      philippe.kolh@chu.ulg.ac.be
FAU - Lahaye, L
AU  - Lahaye L
FAU - Gerard, P
AU  - Gerard P
FAU - Limet, R
AU  - Limet R
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Insufficiency/mortality/*surgery
MH  - Aortic Valve Stenosis/mortality/*surgery
MH  - Coronary Artery Bypass
MH  - Female
MH  - *Heart Valve Prosthesis Implantation
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 1999/08/24 00:00
MHDA- 1999/08/24 00:01
CRDT- 1999/08/24 00:00
PHST- 1999/08/24 00:00 [pubmed]
PHST- 1999/08/24 00:01 [medline]
PHST- 1999/08/24 00:00 [entrez]
AID - S1010794099001463 [pii]
AID - 10.1016/s1010-7940(99)00146-3 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 1999 Jul;16(1):68-73. doi: 
      10.1016/s1010-7940(99)00146-3.