title: Long term clinical and echocardiographic results of isolated aortic valve replacement in elderly patients.
abstract: Results after isolated aortic valve replacement with bileaflet prostheses in patients over 70 years old were reviewed. One-hundred-twenty-eight elderly patients were operated on between January 1988 and January 2000. Patients with associated heart disease were excluded from the study. Preoperative data, early and late postoperative mortality, all valve related complications and data concerning anticoagulation status were recorded. Hospital mortality was 9.3%. Mean follow-up time was 60.98 +/- 2.23 months. Twelve-year actuarial survival was 69.6 +/- 0.08%. Valve related and anticoagulation related complication rates (0.8% and 1.6% respectively) and actuarial freedom (99 +/- 0.009 both) were low, as well as the mean interval between consecutive INR checks (18.39 +/- 1.90 days) and the mean INR value (2.17 +/- 0.135). Late echocardiographic results showed low postoperative mean transprosthetic gradients (15.48 +/- 0.94). Bileaftlet prostheses in the elderly can achieve excellent results with a low incidence of anticoagulation related complications and low risk of reoperation. Older age can no longer be considered a contraindication to bileaftlet prosthesis implant.
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, V. Monaldi Hospital, Italy.
authors.forename: M
authors.initials: M
authors.lastname: De Feo
authors.forename: A
authors.initials: A
authors.lastname: Renzulli
authors.forename: M
authors.initials: M
authors.lastname: Vicchio
authors.forename: F
authors.initials: F
authors.lastname: Onorati
authors.forename: G
authors.initials: G
authors.lastname: Dialetto
authors.forename: L S
authors.initials: LS
authors.lastname: De Santo
authors.forename: A
authors.initials: A
authors.lastname: Della Corte
authors.forename: M
authors.initials: M
authors.lastname: Cotrufo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D016001:Confidence Intervals; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate