Outcome after aortic valve replacement in octogenarians.
BACKGROUND
The advancing age of the population in the western world and improvements in surgical techniques and postoperative care have resulted in an increasing number of very elderly patients undergoing cardiac operations. Therefore, the aim of this study is to evaluate the surgical outcome in 115 octogenarians after aortic valve replacement.


METHODS
We retrospectively identified 115 patients (47 men, 68 women) aged 82.3 +/- 2.1 years (mean, 80 to 92 years) who underwent aortic valve replacement alone (71 patients, 62.1%) or in combination with coronary artery bypass grafting (44 patients, 37.9%), between January 1992 and April 2003. These patients had significant severe aortic stenosis with a mean valve area of 0.62 +/- 0.15 cm(2) and a mean gradient of 88.62 +/- 24.06 mm Hg.


RESULTS
The in-hospital mortality rate was 8.5%. The late follow-up was 100% complete. Actuarial survival at 1 and 5 years was 86.4% and 69.4%, respectively. Predictors of late mortality were ejection fraction (p < 0.01), preoperative heart failure (p < 0.03), and the type of prosthesis (p < 0.03).


CONCLUSIONS
The outcome after aortic valve replacement in octogenarians is excellent; the operative risk is acceptable and the late survival rate is good. Therefore, cardiac surgery should not be withheld on the basis of age alone.
Chiappini
Bruno
B
Department of Cardiovascular Surgery, University of Bologna, Italy. bruno_chiappini@hotmail.com
Camurri
Nicola
N
Loforte
Antonio
A
Di Marco
Luca
L
Di Bartolomeo
Roberto
R
Marinelli
Giuseppe
G
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D002315:Cardiopulmonary Bypass; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007036:Hypothermia, Induced; D015993:Life Tables; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome