Mechanical versus biological aortic valve implants in the elderly. A comparison of early and mid-term results.
OBJECTIVE
Our aim was to compare, in a non randomized study, the surgical outcome in elderly patients with mechanical (Group 1; n=83) and bioprosthetic valve implants (Group 2; n=136).


METHODS
During a three year period, 219 patients >75 years underwent Aortic Valve Replacement. The groups matched according to age, sex, comorbidity, valve pathology and concomitant Coronary Artery Bypass Surgery. Follow-up was a total of 469 patient-years (mean follow-up 2.1 years, maximum 4,4 years).


RESULTS
Operative mortality was zero and the overall early mortality was 2.3 % (within 30 days). Actuarial survival was 87.5 +/- 4.0% and 66.1 +/- 7.7% (NS) at 4 years in Group 1 and Group 2, respectively. Freedom from valve-related death was 88.9 +/- 3.8% in Group 1 and 69.9+/-7.9% (NS) in Group 2 at 4 years.


CONCLUSIONS
Aortic Valve Replacement in the elderly (>75 years) is a safe procedure even in cases where concomitant coronary artery revascularization is performed. Only a few anticoagulant-related complications were reported and this may indicate that selected groups of elderly patients with significant life expectancy may benefit from mechanical implants.
Thulin
L I
LI
Heart Valve Section, Division of Heart and Lung Diseases, University Hospital of Lund, Lund, Sweden. lars.thulin@thorax.lu.se
Sjögren
J L
JL
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome