Surgery for aortic stenosis in severely symptomatic patients older than 80 years: experience in a single UK centre.
OBJECTIVE
To ascertain the surgical risk and long term outcome of patients over 80 years old undergoing aortic valve replacement (AVR).


METHODS
Consecutive cases with respective case note audit and a telephone questionnaire.


METHODS
Single UK cardiothoracic surgical centre.


METHODS
103 (48 male) patients over 80 years old undergoing AVR. The median age was 82 years (80-95 years) and 95 of 103 patients were in New York Heart Association (NYHA) class III or IV.


RESULTS
Preoperative characteristics, operative course, cost, and outcome measures were ascertained. Mean bypass time was 56 minutes and 25 patients had simultaneous coronary artery bypass grafting. Overall mortality was 19 of 103. Univariate analysis of pertinent variables found that impaired renal function and peripheral vascular disease were significantly associated with early postoperative death. 10 of 12 patients requiring ventilation for more than 24 hours died. The 50% actuarial survival was 62 months. Late complications were uncommon with 92% of patients in NYHA class I or II at follow up.


CONCLUSIONS
AVR in patients over 80 years old has a significant risk. However, those patients who survive experience significant benefit with good long term prospects for general health and social independence.
Department of Cardiology, John Radcliffe Hospital, Oxford OX3 9DU, UK.
T
T
Gilbert
W
W
Orr
A P
AP
Banning
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000191:economics / Q000401:mortality; D003365:Costs and Cost Analysis; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000191:economics / Q000401:mortality; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000401:mortality; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome