title: Aortic valve replacement with and without coronary artery bypass graft surgery in octogenarians: is it safe and feasible?
abstract: BACKGROUND
  Octogenarians are often denied complex surgical intervention. We evaluated the rationality of this bias by comparing the outcomes of octogenarians undergoing aortic valve replacement (AVR) with or without coronary artery bypass grafting (CABG), to those of younger patients.
  
  
  METHODS
  Data on 476 patients (≥ 80 years) who underwent AVR or AVR/CABG were compared to the Society of Thoracic Surgeons (STS) database.
  
  
  RESULTS
  One hundred and seventeen octogenarians underwent AVR and 263 underwent AVR/CABG. Preoperative comorbidity rates were similar between these 2 respective groups, except for diabetes mellitus (18.8 vs. 30.4%, p = 0.02), previous cardiac stent placement (5.1 vs. 17.9%, p = 0.0006) and prior CABG (8.5 vs. 0.8%, p = 0.0002) and mortality did not differ significantly (5.1 vs. 7.6%, p = 0.51). Multivariate analysis identified preoperative chronic renal failure [odds ratio (OR) = 0.09, p < 0.048], postoperative arrhythmia (OR = 0.29, p < 0.022), sepsis (OR =37.38, p < 0.000), pneumonia (OR = 8.29, p < 0.038) and renal failure (OR = 10.16, p < 0.000) with increased rates of in hospital mortality in AVR alone and AVR/CABG.
  
  
  CONCLUSIONS
  AVR alone or AVR/CABG can be safely performed in patients ≥ 80 years with acceptable morbidity/mortality rates. An age of ≥ 80 years is not an independent risk factor predictive of increased in hospital mortality
authors: Department of Surgery, Saint Barnabas Medical Center, Livingston, N.J. 07039, USA.
authors: N J
authors: NJ
authors: Abel
authors: G J
authors: GJ
authors: Rogal
authors: P
authors: P
authors: Burns
authors: C R
authors: CR
authors: Saunders
authors: R S
authors: RS
authors: Chamberlain
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome