title: Risk profile and outcomes of aortic valve replacement in octogenarians.
abstract: OBJECTIVE
  To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR).
  
  
  METHODS
  Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Infirmary. Demographics, acute outcomes, length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were defined: LES ≥ 15 (n = 80) and LES < 15 (n = 193).
  
  
  RESULTS
  In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identified a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR.
  
  
  CONCLUSIONS
  It may be better treated with transcatheter aortic valve implantation.
authors: Sujatha Kesavan, Academic Tutor and Research Fellow in Cardiology, University of Bristol and Bristol Heart Institute, Bristol BS2 8HW, United Kingdom.
authors: Sujatha
authors: S
authors: Kesavan
authors: Aamer
authors: A
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authors: Yusra
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authors: Khan
authors: Jonathan
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authors: Hutter
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authors: Pike
authors: Chris
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authors: Rogers
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authors: Turner
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