title: Outcomes of surgical aortic valve replacement in octogenarians.
abstract: BACKGROUND
  In the era of TAVI, there has been renewed interest in the outcomes of conventional AVR for high-risk patients. This study evaluates the short- and long-term outcomes of AVR in octogenarians.
  
  
  METHODS
  A retrospective review was performed of all 117 patients aged ≥ 80 years who underwent AVR, (isolated AVR (n = 60) or AVR+CABG (n = 57),) from August 2005 to February 2011 at Royal Prince Alfred Hospital and Strathfield Hospital. Univariate analysis was used to compare pre- and post-operative variables between younger and older subgroups (age 80-84, n = 82; age 85-89, n = 35 respectively). Long-term survival data was obtained from the National Death Index at the Australian Institute of Health and Welfare and survival curves were constructed using the Kaplan-Meier method.
  
  
  RESULTS
  The median age was 83 years (interquartile range, 81-85 years), 46.2% were females, the median EuroSCORE was 10.89% (interquartile range, 8.20-16.45%) and 16.2% of patients had a EuroSCORE ≥ 20%. The difference between subgroups for history of stroke was significant (p = .042). Post-operative complications included pleural effusion (12.8%), new renal failure (4.3%) and respiratory failure (4.3%). The rate of major adverse events was extremely low, with no cases of stroke. The 30-day mortality rate was 3.4%. There was a significant difference between subgroups for 30-day mortality (p = .007). 38.9% of patients were discharged home, 11.5% were transferred to another hospital and 38.9% spent a period of time in a rehabilitation institution post discharge. In terms of long-term survival, the six-month, one-year and three-year survival was 95.6%, 87.6% and 58.4% respectively.
  
  
  CONCLUSIONS
  Surgical AVR yields excellent short- and long-term outcomes for potentially high-risk, elderly patients.
authors: Central Clinical School, Faculty of Medicine, University of Sydney, Australia.
authors: Rebecca S
authors: RS
authors: Harris
authors: Tristan D
authors: TD
authors: Yan
authors: Deborah
authors: D
authors: Black
authors: Paul G
authors: PG
authors: Bannon
authors: Matthew S
authors: MS
authors: Bayfield
authors: P Nicholas
authors: PN
authors: Hendel
authors: Michael K
authors: MK
authors: Wilson
authors: Michael P
authors: MP
authors: Vallely
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000209:etiology / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D051437:Renal Insufficiency / Q000209:etiology / Q000378:metabolism / Q000601:surgery; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors
keywords: Aortic valve replacement; Octogenarians