PMID- 8666861
OWN - NLM
STAT- MEDLINE
DCOM- 19960806
LR  - 20110727
IS  - 0369-4739 (Print)
IS  - 0369-4739 (Linking)
VI  - 44
IP  - 4
DP  - 1996 Apr
TI  - [Valvular surgery in the patients more than 70 years old].
PG  - 453-8
AB  - One hundred twenty-eight valvular surgeries in patients over 70-year-old were 
      reviewed (AVR:58, MVR:38, AVR and MVR: 11, mitral valvuloplasty (MVP): 11, AVR + 
      MVP:11, mitral valvuloplasty (MVP): 11, AVR + MVP: 8, others: 2). Concomitant 
      CABG was performed in 7, Maze in 6, TVR in 5 and Bentall in 3 cases. Early deaths 
      occurred in 17 patients (13%). The early mortality was 5% in AVR, 21% MVR, 18% in 
      AVR and MVR, 0% in MVP and 38% in AVR and MVP. Late death occurred in 16 
      patients. Forty-three percent of the late deaths were cardiac death. The 
      actuarial survival at 10 years was around 50% in all groups. In the aortic 
      position, a mechanical valve was implanted in 47 cases and a bioprosthetic valve 
      was implanted in 33 cases. In the mitral position, the mechanical valve was 
      implanted in 37 cases and the bioprosthetic valve was implanted in 12 cases. The 
      event free rate after AVR at 10 years was 37% in patients with the mechanical 
      valve (3 cerebral hemorrhage, 2 PVE, 1 thromboembolism and 1 sudden death) and 
      46% in patients with the bioprosthetic valve (2 PVE and 1 primary tissue 
      failure). The event free rate after MVR at 10 years was 84% in patients with 
      mechanical valves (1 perivalvular leak, 1 PVE and 1 sudden death) and 75% in 
      patients with bioprosthetic valves (1 PVE and 1 sudden death). Between mechanical 
      valve group and bioprosthesis group, no statistically significance was found in 
      the event free curve after AVR nor MVR. There was no valve related event after 
      MVP. Considering the better durability of bioprostheses in the aortic position 
      than in the mitral position, the presence of atrial fibrillation and necessity of 
      warfarin anticoagulation, we conclude that a choice of a bioprosthetic valve 
      could be acceptable in the aortic position, but may not be recommended in the 
      mitral position.
FAU - Nakano, K
AU  - Nakano K
AD  - Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, 
      Japan.
FAU - Eishi, K
AU  - Eishi K
FAU - Kobayashi, J
AU  - Kobayashi J
FAU - Sasako, Y
AU  - Sasako Y
FAU - Isobe, F
AU  - Isobe F
FAU - Kosakai, Y
AU  - Kosakai Y
FAU - Kito, Y
AU  - Kito Y
FAU - Kawashima, Y
AU  - Kawashima Y
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Nihon Kyobu Geka Gakkai Zasshi
JT  - [Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
JID - 19130180R
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Bioprosthesis/*mortality
MH  - Coronary Artery Bypass
MH  - Female
MH  - Heart Valve Prosthesis/*mortality
MH  - Heart Valves/*surgery
MH  - Humans
MH  - Male
MH  - Prognosis
EDAT- 1996/04/01 00:00
MHDA- 1996/04/01 00:01
CRDT- 1996/04/01 00:00
PHST- 1996/04/01 00:00 [pubmed]
PHST- 1996/04/01 00:01 [medline]
PHST- 1996/04/01 00:00 [entrez]
PST - ppublish
SO  - Nihon Kyobu Geka Gakkai Zasshi. 1996 Apr;44(4):453-8.