title: Quality-of-life in octogenarians one year after aortic valve replacement with or without coronary artery bypass surgery.
abstract: The increasing number of interventions for percutaneous aortic valve replacement (AVR) justify a renewed evaluation of one-year survival rates after open AVR with and without coronary artery bypass in octogenarians. Risk factors influencing mortality are compared, and the patients' quality-of-life (QoL) after one year is assessed. One hundred and fifty-four patients (102 females, 52 males) aged on average 82.9±2.5 years, who had undergone open bioprosthetic AVR with (n=80) and without (n=74) coronary artery bypass grafting (CABG) between January 2005 and December 2007 were reviewed retrospectively. Risk factors for mortality were analyzed. The patient's QoL after one year was evaluated by administering the Seattle Angina Questionnaire on the telephone. The mean in-hospital mortality rate was 7.8%. The 12-month survival rate was 81.8%. Preoperative risk factors revealed no difference between survivors and non-survivors: renal insufficiency, chronic obstructive pulmonary disease (COPD), diabetes, cerebrovascular disease (CVD), peripheral vascular disease, logistic EuroSCORE and concomitant CABG. Assessment of QoL revealed a substantial improvement of physical fitness in all 126 patients. Surgery in the aortic valve without CABG is associated with a good outcome. The improvement in QoL after one year supports the decision to operate on patients older than 80 years of age.
authors.affiliation: Department of Cardiac Surgery, Hospital Hietzing, Wolkersbergenstr. 1, 1130 Vienna, Austria. s.folkmann@gmx.at
authors.forename: Sandra
authors.initials: S
authors.lastname: Folkmann
authors.forename: Michael
authors.initials: M
authors.lastname: Gorlitzer
authors.forename: Gabriel
authors.initials: G
authors.lastname: Weiss
authors.forename: Marieluise
authors.initials: M
authors.lastname: Harrer
authors.forename: Markus
authors.initials: M
authors.lastname: Thalmann
authors.forename: Peter
authors.initials: P
authors.lastname: Poslussny
authors.forename: Martin
authors.initials: M
authors.lastname: Grabenwoger
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001317:Austria; D001705:Bioprosthesis; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000523:psychology; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality / Q000523:psychology; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome