title: Results of aortic valve surgery in patients over 75 years old, at 4.5 years of follow-up.
abstract: BACKGROUND
  The increased longevity elevated the frequency of elderly requiring surgery, among them the correction of aortic stenosis.
  
  
  OBJECTIVE
  To evaluate medium-term mortality, need for reoperation for valve replacement and valve complications [systemic thromboembolism (STE) and prosthetic endocarditis (PE)] in patients over 75 years old who had undergone surgery for aortic stenosis.
  
  
  METHODS
  Retrospective study of 230 patients from 2002 to 2007. Mean age was 83.4 years and 53% were male. The prevalence of hypertension was 73.2%, atrial fibrillation 17.9% and previous cardiac surgery 14.4%. Another cardiac procedure was associated in 39.1%.
  
  
  RESULTS
  In a mean follow-up of 4.51 years the overall survival of the population studied was 57.4%. Death in the immediate postoperative period occurred in 13.9% (9.4% in the isolated aortic stenosis surgery group vs. 20.9% when another procedure was associated). Deaths in the medium term occurred in 28.7% of the patients (25.0% vs. 34.4%), with 34 of these because of cardiovascular causes. There were 6 cases of PE, 8 cases of STE and 6 reoperations. The predictors of mortality were ischemia time >90 min (OR 1.99 95% CI 1.06-3.74), ejection fraction <60% (OR 1.76 95% CI 1.10-2.81) and prior stroke (OR 2.43 95% CI 1.18-5.30).
  
  
  CONCLUSIONS
  Although the immediate surgical risk of the elderly is high, survival rates for surgical treatment of patients over 75 years old are acceptable and allow this intervention. The prognosis is worse especially because of the association with coronary artery disease.
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Tagliari
authors.forename: Fernando
authors.initials: F
authors.lastname: Pivatto Júnior
authors.forename: Felipe Homem
authors.initials: FH
authors.lastname: Valle
authors.forename: João Ricardo Michelin
authors.initials: JR
authors.lastname: Sant'anna
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Prates
authors.forename: Ivo Abrahão
authors.initials: IA
authors.lastname: Nesralla
authors.forename: Renato Abdala Karam
authors.initials: RA
authors.lastname: Kalil
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality* / Q000601:surgery*; D001938:Brazil; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality*; D008297:Male; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome