PMID- 15553309
OWN - NLM
STAT- MEDLINE
DCOM- 20050830
LR  - 20200225
IS  - 0160-9289 (Print)
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 27
IP  - 10
DP  - 2004 Oct
TI  - Aortic valve replacement in patients 70 years and older.
PG  - 565-70
AB  - BACKGROUND: Aortic valvular disease is the most common valvular lesion among 
      elderly patients. Because of changing demographics, it has become increasingly 
      frequent. Aortic valve replacement (AVR) is the only effective treatment for 
      aortic valvular disease. HYPOTHESIS: This study was undertaken to evaluate the 
      results of AVR in an elderly population. METHODS: Data were retrospectively 
      analyzed in 117 consecutive patients (mean age 73.8 years) who underwent AVR 
      between 1991 and 2002. RESULTS: Pure or predominant severe aortic stenosis was 
      present in 108 patients. Nine patients had severe aortic regurgitation. Before 
      valve replacement, 62.4% of the patients were in New York Heart Association 
      (NYHA) functional class III-IV. A bioprosthesis was implanted in 62.4% of the 
      patients, and 37.6% received a mechanical valve. Concomitant cardiac surgical 
      procedures were performed in 25 patients (coronary artery bypass graft in 22, 
      mitral valve replacement in 3). There were 17 deaths, giving a perioperative 
      mortality rate of 14.5%. Multivariate logistic regression showed that repeat 
      surgery for bleeding, prolonged cardiopulmonary bypass time, postoperative 
      respiratory failure, and postoperative acute renal insufficiency were significant 
      independent predictors of operative mortality. Of the 100 hospital survivors, 78 
      were followed for a mean of 42.9 months. There were six deaths during follow-up; 
      only two of these were cardiac related. Five-year actuarial survival for all 
      patients and for hospital survivors were 70 and 91.1%, respectively. One year 
      post surgery, all patients were in NYHA functional class I-II. CONCLUSION: In a 
      selected patient population, AVR in the elderly is associated with acceptable 
      mortality and morbidity. The outlook for hospital operative survivors is 
      excellent with improved quality of life and an expected survival normal for this 
      particular age.
FAU - Salazar, Eduardo
AU  - Salazar E
AD  - Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico, DF. 
      edsalazar00@yahoo.com
FAU - Torres, Jorge
AU  - Torres J
FAU - Barragan, Rodolfo
AU  - Barragan R
FAU - Lopez, Mauricio
AU  - Lopez M
FAU - Lasses, Luis Alberto
AU  - Lasses LA
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Aged
MH  - Aortic Valve/*surgery
MH  - Aortic Valve Insufficiency/*surgery
MH  - Aortic Valve Stenosis/*surgery
MH  - Blood Pressure/physiology
MH  - Cause of Death
MH  - Coronary Artery Bypass
MH  - Coronary Artery Disease/surgery
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Mitral Valve Insufficiency/surgery
MH  - Multivariate Analysis
MH  - Postoperative Complications/epidemiology/etiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume/physiology
MH  - Survival Analysis
MH  - Time
MH  - Treatment Outcome
PMC - PMC6654741
EDAT- 2004/11/24 09:00
MHDA- 2005/09/01 09:00
PMCR- 2006/12/05
CRDT- 2004/11/24 09:00
PHST- 2004/11/24 09:00 [pubmed]
PHST- 2005/09/01 09:00 [medline]
PHST- 2004/11/24 09:00 [entrez]
PHST- 2006/12/05 00:00 [pmc-release]
AID - CLC4960271009 [pii]
AID - 10.1002/clc.4960271009 [doi]
PST - ppublish
SO  - Clin Cardiol. 2004 Oct;27(10):565-70. doi: 10.1002/clc.4960271009.