PMID- 2383107
OWN - NLM
STAT- MEDLINE
DCOM- 19900907
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 50
IP  - 2
DP  - 1990 Aug
TI  - Severe aortic stenosis in octogenarians: is operation an acceptable alternative?
PG  - 226-9
AB  - From 1981 to 1989, 60 patients more than 80 years of age were referred for 
      operation for severe calcific aortic stenosis. All patients were symptomatic: 13 
      in New York Heart Association (NYHA) functional class II, 28 in class III, and 19 
      in class IV. The preoperative mean cardiothoracic ratio was 0.58 +/- 0.09; the 
      mean valve area, 0.52 +/- 0.14 cm2; and the mean aortic valve gradient, 62 +/- 18 
      mm Hg. Left ventricular function was impaired in 30 patients (ejection fraction 
      less than 0.40). Coronary arteriography was performed in 10 patients. Aortic 
      replacement used bioprosthesis in all 60 patients associated with aortocoronary 
      bypass (in 5) and mitral valve replacement (in 1). One-month mortality rate was 
      28% (17 patients) due to cardiac failure (in 9), pulmonary complications (in 6), 
      and neurological complications (in 2). Early mortality was not correlated with 
      preoperative angina, cardiothoracic ratio, associated operation, and 
      cross-clamping time. It was not obviously correlated with preoperative functional 
      class but correlated positively with urgent operations and with left ventricular 
      function (40% mortality in patients with ejection fraction less than 0.40 versus 
      16% mortality in others). Hospital morbidity was 68%. Mean hospitalization was 15 
      +/- 7 days. There were four late deaths. Thirty-nine patients are long-term 
      survivors (3 months to 7 years): 27 in class I, 10 in class II, and 2 in class 
      III due to primary valve failure. The actuarial survival probability is 65% at 1 
      year and 61% at 5 years. In summary, the good long-term quality of life justifies 
      the high postoperative risk in octogenarians. Early operation before cardiac 
      function impairment improves the results.
FAU - Deleuze, P
AU  - Deleuze P
AD  - Service de Chirurgie Thoracique et Cardiovasculaire, CHU. Henri Mondor, Creteil, 
      France.
FAU - Loisance, D Y
AU  - Loisance DY
FAU - Besnainou, F
AU  - Besnainou F
FAU - Hillion, M L
AU  - Hillion ML
FAU - Aubry, P
AU  - Aubry P
FAU - Bloch, G
AU  - Bloch G
FAU - Cachera, J P
AU  - Cachera JP
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 1990 Aug;50(2):173-4. PMID: 2383100
MH  - Actuarial Analysis
MH  - Aged
MH  - *Aged, 80 and over
MH  - Aortic Valve
MH  - Aortic Valve Stenosis/mortality/*surgery
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - Humans
MH  - Male
MH  - Quality of Life
MH  - Risk Factors
MH  - Survival Rate
MH  - Time Factors
EDAT- 1990/08/01 00:00
MHDA- 1990/08/01 00:01
CRDT- 1990/08/01 00:00
PHST- 1990/08/01 00:00 [pubmed]
PHST- 1990/08/01 00:01 [medline]
PHST- 1990/08/01 00:00 [entrez]
AID - 0003-4975(90)90739-S [pii]
AID - 10.1016/0003-4975(90)90739-s [doi]
PST - ppublish
SO  - Ann Thorac Surg. 1990 Aug;50(2):226-9. doi: 10.1016/0003-4975(90)90739-s.