title: Aortic valve reconstruction using autologous pericardium for ages over 80 years.
abstract: BACKGROUND
  We performed original aortic valve reconstruction using autologous pericardium; the feasibility for elderly patients is reviewed.
  
  
  METHODS
  From April 2007 through September 2011, aortic valve reconstruction was carried out in 86 patients over the age of 80 years. Twenty-seven patients were male and 59 were female. Mean age was 82.9 ± 2.5 years. Seventy-two patients had aortic stenosis and 14 had aortic regurgitation. Mean preoperative surgical annular diameter was 19.5 ± 2.5 mm. There were 80 (90.7%) cases of small aortic annulus. Mean preoperative logistic EuroSCORE was 22.9 ± 15.8.
  
  
  RESULTS
  Isolated aortic valve reconstructions were performed in 51 patients. Concomitant procedures included coronary artery bypass grafting in 6, hemiarch aortic replacements in 6, 9 maze procedures, and some combinations. No conversion to valve replacement was required. Mean follow-up was 1243 days. There were 3 hospital deaths due to noncardiac causes. No reoperation was needed. Survival at 56 months was 87.0%. No thromboembolic event occurred. Echocardiography 3.5 years after surgery revealed an average peak pressure gradient of 14.6 ± 3.8 mm Hg. No moderate or severe regurgitation was recorded.
  
  
  CONCLUSIONS
  Aortic valve reconstruction is feasible for patients older than 80 years, resulting in good hemodynamics and a better quality of life, without anticoagulation.
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan ozakis@oha.toho-u.ac.jp.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ozaki
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Kawase
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Uchida
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Yukinari
authors.initials: Y
authors.lastname: Nozawa
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Takatoh
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: So
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Nagaki
authors.initials: N
authors.lastname: Kiyohara
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D010496:Pericardium / Q000637:transplantation*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: 80 and over; Aged; Aortic valve; Aortic valve stenosis; Autografts; Pericardium; Treatment outcome