Functional quality of life following open valve surgery in high-risk octogenarians.
OBJECTIVE
The aim of this study was to determine the midterm functional quality of life in octogenarians after open valvular surgery.


METHODS
One hundred and eighty-five consecutive patients above age 80 had valvular surgery with or without coronary artery bypass grafting (CABG). Using the Karnofsky Performance score and Barthel Index, patients were evaluated for functional autonomy, living disposition, and leisure activity by a single telephone interview. Subgroup analysis was performed on the 49 cases of isolated aortic valve replacement (AVR).


RESULTS
Mean age of octogenarians undergoing valvular surgery was 82.7 years (range 80 to 92 years). Actuarial survival at one and three years was 71% and 59%, respectively, for the entire group, compared to 84% and 71%, respectively, for isolated AVRs. After a mean follow-up of 38 months there were 110 survivors (59.5%). Among survivors, 66% were autonomous, 26% semiautonomous, and 8% deemed dependent. Seventy-two percent were living at home, 19% in a residence, and 9% in a supervised nursing facility. Over 90% of patients pursued leisure activities in the social, cognitive, and physical domains.


CONCLUSIONS
Valvular surgery in high-risk octogenarians, can be performed with acceptable mortality rates, and provide patients with functional autonomy and an excellent quality of life.
Division of Cardiac Surgery, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada.
Stephane
S
Leung Wai Sang
Rakesh K
RK
Chaturvedi
Sameena
S
Iqbal
Kevin
K
Lachapelle
Benoit
B
de Varennes
D000203:Activities of Daily Living; D000367:Age Factors; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000534:rehabilitation / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D057187:Independent Living; D007407:Interviews as Topic; D007899:Leisure Activities; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D026684:Personal Autonomy; D011788:Quality of Life; D012112:Residential Facilities; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome