Aortic valve preservation surgery in elderly patients with aortic stenosis.
OBJECTIVE
The aim of the present study was to investigate early and late results of the aortic valve preservation surgery (AVPS) through rough-hewing, demineralization and commissurotomy of the aortic valve (AV) in aortic stenosis (AS) at elderly people.


METHODS
Thirty-two patients operated for pure AS, older than 65 years-old were studied at InCor FMUSP. Early and late results, clinical (ambulatory and phone interview) and echocardiographic follow-up were investigated. Actuarial and event-free survival analysis was done using the Kaplan-Meier method.


RESULTS
Four patients (15.4%) had presented de novo AV stenosis. Five patients had progressed to moderate and two to serious aortic regurgitation. Demineralization, commissurotomy and rough-hewing were realized in 28, 20 and 16 patients, respectively. Nine patients had presented serious postoperative complications (28.1%). Two hospital-acquired pneumonia sepsis and five late deaths had occurred. Postoperative NYHA functional status were 70.5%, 17.6%, 5.8% and 5.8% for functional classes I, II, III and IV, respectively. Actuarial eight-year survival rate was 66.9 +/- 12.1%. Eight-year free thromboembolism and endocarditis rate were 90.9 +/- 8.7% and 100%, respectively.


CONCLUSIONS
Aortic valve preservation surgery at the aged with AS was revealed a low morbidity and mortality procedure and presented an eight-year acceptable survival rate and functional status improvement among the studied series of patients.
Segalote
Rodrigo Coelho
RC
Heart Institute of the Clinics Hospital, Faculty of Medicine, University of São Paulo, Rua Dr. Enéas de Carvalho Aguiar no. 44, São Paulo-SP, Brazil. segalote@yahoo.com.br
Pomerantzeff
Pablo Maria Alberto
PM
Brandão
Carlos Manuel de Almeida
CM
Stolf
Noedir Antônio Groppo
NA
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate