title: [Aortic valve replacement with bioprosthesis in patients 70 years old or older with aortic stenosis].
abstract: BACKGROUND
  Aortic valve stenosis is the most prevalent valvulopathy in the elderly, but it is frequently undertreated.
  
  
  OBJECTIVE
  To assess early and long term results of valve replacement with bioprostheses in patients 70 years old or older with aortic stenosis.
  
  
  METHODS
  A review of the database of the Cardiovascular Surgery Service of our hospital, for the period 1990-2007, identified 156 patients with aortic valve stenosis, aged 76.7 ± 4.5 years (67% males), that were subjected to an aortic valve replacement with bioprosthesis. Seventy eight (50%) were in functional class III-IV. Six patients had emergency surgery. In 67 patients (43%) coronary artery bypass graft were performed. Long term mortality was ascertained obtaining death records from Chilean death registry.
  
  
  RESULTS
  Operative mortality was 3.2% (5 patients). Four patients (2.6%) required a reoperation due to bleeding. The mean follow up was 66 ± 41 months. The survival rate at 1, 3 and 5 years was 94%, 88% and 80%, respectively. Forty two patients (27%) were 80 years old or older. In this sub-group, 1 patient (2.3%) died during the peri operative period and the estimated survival rate at 1, 3 and 5 years was 97%, 92%, and 80%, respectively. Multivariate risk analysis, for the whole group, identified low ejection fraction and concomitant coronary artery bypass graft surgery as predictors of late mortality.
  
  
  CONCLUSIONS
  Aortic valve replacement for aortic stenosis with bioprostheses in patients 70 years old or older had low perioperative mortality and morbidity and a good long term survival.
authors.affiliation: División de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. rzalaque@med.puc.cl
authors.forename: Ricardo
authors.initials: R
authors.lastname: Zalaquett
authors.forename: Gabriel
authors.initials: G
authors.lastname: Olivares
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mejía
authors.forename: Felipe
authors.initials: F
authors.lastname: Quezada
authors.forename: Oslando
authors.initials: O
authors.lastname: Padilla
authors.forename: Pedro
authors.initials: P
authors.lastname: Becker
authors.forename: Manuel
authors.initials: M
authors.lastname: Irarrázaval
authors.forename: Sergio
authors.initials: S
authors.lastname: Morán
authors.forename: Cecilia
authors.initials: C
authors.lastname: Muñoz
authors.forename: Rodrigo
authors.initials: R
authors.lastname: González
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality* / Q000601:surgery; D001705:Bioprosthesis; D002677:Chile / Q000453:epidemiology; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D016019:Survival Analysis; D016896:Treatment Outcome