title: Aortic valve preservation surgery in elderly patients with aortic stenosis.
abstract: 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.
authors.affiliation: 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
authors.forename: Rodrigo Coelho
authors.initials: RC
authors.lastname: Segalote
authors.forename: Pablo Maria Alberto
authors.initials: PM
authors.lastname: Pomerantzeff
authors.forename: Carlos Manuel de Almeida
authors.initials: CM
authors.lastname: Brandão
authors.forename: Noedir Antônio Groppo
authors.initials: NA
authors.lastname: Stolf
mesh_terms: 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