[Surgical indications and prognosis of valvular heart disease and infective endocarditis in the elderly].
To elucidate the surgical results and long-term prognosis in valvular heart disease, including infective endocarditis, in the elderly, 110 patients with valvular heart disease who underwent surgical treatment and 29 patients with infective endocarditis were studied. Among the patients with valvular heart disease, 52 patients (21 elderly, 31 young) underwent aortic valve replacement, 46 patients (24 elderly, 22 young) mitral valve replacement, and 12 patients (6 elderly, 6 young) double valve replacement. There were only 2 operative deaths (1 elderly, 1 young). The 5-year survival rate was 91.2% in elderly patients and 92.3% in younger patients. The five-year event-free rate was 67.3% in elderly patients and 79.0% in younger patients. Among 29 patients with infective endocarditis, surgical treatment was successfully performed in six of the 13 elderly patients and 10 of the 16 younger patients. There were two deaths among the younger patients and no death among the elderly patients, although recurrence was found in 2 elderly patients. Good results can be obtained from surgical intervention in elderly patients, provided they are risk-stratified before surgery followed by appropriate management.
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Department of Medicine & Geriatrics, Kochi Medical School.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004697:Endocarditis, Bacterial / Q000401:mortality / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate