PMID- 29701365
OWN - NLM
STAT- MEDLINE
DCOM- 20190523
LR  - 20220330
IS  - 0873-7215 (Print)
IS  - 0873-7215 (Linking)
VI  - 24
IP  - 3-4
DP  - 2017 Jul-Dec
TI  - Long-term Outcomes in Octogenarians Following Isolated Aortic Valve Replacement.
PG  - 133
AB  - INTRODUCTION: Isolated aortic valve replacement (AVR) in elderly patients is 
      associated with increased operative risk, due to higher prevalence of associated 
      risk factors and other comorbidities, making outcome prediction essential. In 
      patients with symptomatic severe aortic disease, advanced age is often a reason 
      for a transcatheter rather than surgical aortic valve replacement. In the era of 
      TAVI, there has been renewed interest in the outcomes of conventional AVR for 
      high and intermediate risk patients. This study evaluates the short and long-term 
      outcomes of elective AVR in elderly patients. METHODS: Between July 2011 and May 
      2015, 100 patients, aged 80 years or older, underwent elective AVR in our unit. 
      The notes of these patients were retrospectively reviewed and follow-up 
      information was obtained from their cardiologists and general practitioners. The 
      average age was 82.8+/-2.3 years, 53.0% were female, 96.0% had severe aortic valve 
      stenosis and their mean EuroSCORE II was 4.1+/-3.2 (intermediate risk). 
      Preoperatively, 35.0% of patients were in NYHA class III or IV. Statistical 
      analyses were done using IBM SPSS version 24. RESULTS: Median UCI and hospital 
      stay was 2.0+/-3.7 and 7.0+/-9.5 days, respectively. Post-operatively, 2 patients 
      required insertion of a permanent pacemaker, 3 patients suffered an ischemic 
      stroke without sequelae, 3 required temporary renal replacement therapy, 7 
      required resternotomy for bleeding, 3 had sternal wound infections. No myocardial 
      infarction was observed. In-hospital mortality was 4.0%, which was in accordance 
      with the mean EuroSCORE II (4.1+/-3.2, p>0.05). One- year survival was 85.0%, 
      three-year survival was 81.4% and five-year survival was 59.4%. At follow-up, 
      96.0% of patients were New York Heart Association (NYHA) Class I or II and 2 late 
      endocarditis occurred and were medically treated. Structural valve deterioration 
      was observed in 2 patients at 3 years follow-up. CONCLUSION: The outcome after 
      AVR in octogenarians is satisfactory; the operative risk is acceptable and might 
      even be reduced with an individual approach to perioperative management in 
      high-risk patients. Patient age should not be the primary exclusion for 
      conventional cardiac surgery for aortic valve disease.
FAU - Simoes Costa, Sara
AU  - Simoes Costa S
AD  - Servico de Cirurgia Cardiotoracica, Centro Hopsitalar de Vila Nova de 
      Gaia/Espinho, EPE, Portugal.
FAU - Rijo, Diogo
AU  - Rijo D
AD  - Servico de Cirurgia Cardiotoracica, Centro Hopsitalar de Vila Nova de 
      Gaia/Espinho, EPE, Portugal.
FAU - Monteiro, Joao Pedro
AU  - Monteiro JP
AD  - Servico de Cirurgia Cardiotoracica, Centro Hopsitalar de Vila Nova de 
      Gaia/Espinho, EPE, Portugal.
FAU - Martins, Daniel
AU  - Martins D
AD  - Servico de Cirurgia Cardiotoracica, Centro Hopsitalar de Vila Nova de 
      Gaia/Espinho, EPE, Portugal.
FAU - Santos Paulo, Nelson
AU  - Santos Paulo N
AD  - Servico de Cirurgia Cardiotoracica, Centro Hopsitalar de Vila Nova de 
      Gaia/Espinho, EPE, Portugal.
FAU - Vouga, Luis
AU  - Vouga L
AD  - Servico de Cirurgia Cardiotoracica, Centro Hopsitalar de Vila Nova de 
      Gaia/Espinho, EPE, Portugal.
FAU - Guerra, Miguel
AU  - Guerra M
AD  - Servico de Cirurgia Cardiotoracica, Centro Hopsitalar de Vila Nova de 
      Gaia/Espinho, EPE; Departamento de Cirurgia e Fisiologia, Faculdade de Medicina 
      da Universidade do Porto, Portugal.
LA  - eng
PT  - Journal Article
PL  - Portugal
TA  - Rev Port Cir Cardiotorac Vasc
JT  - Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da 
      Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular
JID - 101154446
SB  - IM
MH  - Aged, 80 and over
MH  - Aortic Valve
MH  - *Aortic Valve Stenosis/surgery
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2018/04/28 06:00
MHDA- 2019/05/24 06:00
CRDT- 2018/04/28 06:00
PHST- 2017/07/18 00:00 [received]
PHST- 2018/04/28 06:00 [entrez]
PHST- 2018/04/28 06:00 [pubmed]
PHST- 2019/05/24 06:00 [medline]
PST - ppublish
SO  - Rev Port Cir Cardiotorac Vasc. 2017 Jul-Dec;24(3-4):133.