PMID- 26953896
OWN - NLM
STAT- MEDLINE
DCOM- 20170201
LR  - 20171206
IS  - 1724-6040 (Electronic)
IS  - 0391-3988 (Linking)
VI  - 39
IP  - 2
DP  - 2016 Feb
TI  - Expectation and quality of life after aortic valve replacement over 85 years of 
      age match those of the contemporary general population.
PG  - 56-62
LID - 10.5301/ijao.5000473 [doi]
AB  - BACKGROUND: In the transcatheter aortic valve implantation (TAVI) years, very 
      elderly patients with aortic stenosis (AS) are referred to surgery with 
      reluctance despite excellent hospital outcomes. A poorly assessed outcome of 
      discharged survivors might further overlook the actual efficacy of the surgical 
      strategy in this cohort. We thus evaluated life-expectancy and functional results 
      in discharged survivors over 85 years operated on for AS. METHODS: Between 
      January 2001 and December 2013, 57 consecutive patients aged >/=85 years underwent 
      aortic valve replacement (AVR) with or without concomitant procedures at our 
      institution. Late survival rate (SR), New York Heart Associaion (NYHA) functional 
      class and quality of life (RAND SF-36) were assessed. SR and quality of life 
      (QoL) were than compared to the contemporary general population matched for age 
      and gender, as calculated by the Italian National Institute of Statistics. 
      RESULTS: Overall in-hospital mortality was 8.8% (5 pts). In patients without 
      concomitant coronary artery bypass grafting (CABG), in-hospital mortality was 
      2.9%. Survival at 5 and 9 years was 57.7 +/- 8.4% and 17.9 +/- 11.4%, respectively. 
      No predictors of late mortality including concomitant CABG were identified at Cox 
      analysis. The mean NYHA class for long-term survivors improved from 3.1 to 1.6 
      (p<0.001). Survivors reported better QoL-scores compared to the age- and 
      gender-matched contemporary general population in 4 RAND SF-36 domains. 
      Life-expectancy resulted comparable to that predicted for the age and 
      gender-matched general population. CONCLUSIONS: Isolated AVR in patients aged >/=85 
      years can be performed with acceptable risk. Survivors improve in NYHA class and, 
      when compared to age- and gender-matched individuals, show a similar life 
      expectancy and a no lower QoL.
FAU - Salsano, Antonio
AU  - Salsano A
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Regesta, Tommaso
AU  - Regesta T
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Vigano, Gaia
AU  - Vigano G
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Rapetto, Filippo
AU  - Rapetto F
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Boeddu, Serena
AU  - Boeddu S
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Sportelli, Elena
AU  - Sportelli E
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Pansini, Stefano
AU  - Pansini S
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Risso, Paolo
AU  - Risso P
AD  - Department of Epidemiology and Social Psychiatry, IRCCS - Mario Negri Institute 
      of Pharmacological Research, Milan - Italy.
FAU - Onorati, Francesco
AU  - Onorati F
AD  - Division of Cardiac Surgery, University of Verona Medical School, Verona - Italy.
FAU - Passerone, Giancarlo
AU  - Passerone G
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
FAU - Santini, Francesco
AU  - Santini F
AD  - Division of Cardiac Surgery, IRCCS San Martino - IST University Hospital, 
      University of Genoa, Genoa - Italy.
LA  - eng
PT  - Journal Article
DEP - 20160229
PL  - United States
TA  - Int J Artif Organs
JT  - The International journal of artificial organs
JID - 7802649
SB  - IM
MH  - Aged, 80 and over
MH  - Aortic Valve/surgery
MH  - Aortic Valve Stenosis/*mortality/*surgery
MH  - Coronary Artery Bypass/mortality
MH  - Coronary Artery Disease/mortality/surgery
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*mortality
MH  - Hospital Mortality
MH  - Humans
MH  - *Life Expectancy
MH  - Male
MH  - Quality of Life
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2016/03/10 06:00
MHDA- 2017/02/02 06:00
CRDT- 2016/03/09 06:00
PHST- 2016/02/04 00:00 [accepted]
PHST- 2016/03/09 06:00 [entrez]
PHST- 2016/03/10 06:00 [pubmed]
PHST- 2017/02/02 06:00 [medline]
AID - 2A5D2295-3A58-4671-8181-1DB3B046459D [pii]
AID - 10.5301/ijao.5000473 [doi]
PST - ppublish
SO  - Int J Artif Organs. 2016 Feb;39(2):56-62. doi: 10.5301/ijao.5000473. Epub 2016 
      Feb 29.