[Valve replacement in patients over 70 years of age].
The extension of cardiac diagnostics by invasive and non invasive, imaging procedures results in an extension of indication for cardiac surgery of patients over 70 years. From August 1977 to July 1985 a total of 212 patients over 70 years were operated upon with extracorporeal circulation for different heart diseases. The mean age was 73.2 years (from 70 to 84 years). In almost 57% (121) of the patients with coronary heart disease (CHD) an aortocoronary venous-bypass (ACVB) was performed, with a mean of 3.3 grafts (ranged from 1 to 5). In 84 patients an isolated or combined heart valve replacement was carried out: Aortic valve replacement (AVR) in 51, mitral valve replacement (MVR) in 11, AVR and MVR in 4, AVR and ACVB in 16 and AVR and aortic ascendens replacement in 2 patients. The overall mortality was 8.5%, with isolated AVR 7.8%, with isolated ACVB it was at the lowest with 5.2%. Postoperative complications could be observed in 48% of patients: low output syndrome (LOS) in 4, arrhythmia in 11, respiratory insufficiency (5%) or stroke in 2, mental confusion in 5. The long-term results after heart valve operation in patients over 70 years emphasize the indication for surgery, despite the higher rate of postoperative complications. The hospital mortality does not differ from that of younger patients. Especially with extreme valvular aortic stenosis after acute AVR one can expect a quick improvement of the cardiac situation after unloading of the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D003327:Coronary Disease / Q000601:surgery; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis
Klappenersatz bei Patienten über 70 Jahre.