title: Aortic valve replacement in octogenarians.
abstract: BACKGROUND
  With improved life expectancy more octogenarians now present with aortic valve disease. Cardiac surgery in this group of patients has previously been considered high risk due to co-morbidities and challenges of rehabilitation. This study seeks to challenge the concept of octogenarian cardiac surgery "unsuitability" by analysing operative outcomes and long term survival following aortic valve replacement.
  
  
  METHODS
  Eighty-seven consecutive patients undergoing aortic valve replacement between 2000 and 2009 at St Vincent's Hospital were retrospectively identified. Statistical analysis was performed using SPSS (version 15 and 19).
  
  
  RESULTS
  The average age was 82.7 ± 2.4 years. The mean logistic EuroSCORE was 18.86 ± 14.11. Post-operatively, four patients required insertion of a permanent pacemaker (4.6%) and five patients had a myocardial infarction (5.8%). In-hospital mortality was 3.4%. Follow-up was 93.1% complete. One-year survival was 92.9%, three-year survival was 86.7% and five-year survival was 75.0%. At follow-up 98.1% of patients were New York Heart Association (NYHA) Class I or II.
  
  
  CONCLUSIONS
  Results were excellent despite reasonable co-morbidities and Euroscore risk. Survival was impressive and the NYHA class reflected the success of the surgery in relieving the pathological aortic valve process. Patient age should not be the primary exclusion for cardiac surgery for aortic valve disease.
authors.affiliation: Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia. Electronic address: jess_ditchfield@hotmail.com.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Ditchfield
authors.affiliation: Department of Cardiothoracic Surgery, St Vincent's Hospital, Darlinghurst, Sydney NSW 2010, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Granger
authors.affiliation: Department of Cardiothoracic Surgery, St Vincent's Hospital, Darlinghurst, Sydney NSW 2010, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Spratt
authors.affiliation: Department of Cardiothoracic Surgery, St Vincent's Hospital, Darlinghurst, Sydney NSW 2010, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Jansz
authors.affiliation: Department of Cardiothoracic Surgery, St Vincent's Hospital, Darlinghurst, Sydney NSW 2010, Australia.
authors.forename: Kumud
authors.initials: K
authors.lastname: Dhital
authors.affiliation: Department of Cardiothoracic Surgery, St Vincent's Hospital, Darlinghurst, Sydney NSW 2010, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Farnsworth
authors.affiliation: Department of Cardiology, St Vincent's Hospital, Darlinghurst, Sydney NSW 2010, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Hayward
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality* / Q000601:surgery*; D001705:Bioprosthesis; D003422:Critical Care; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D056346:Sternotomy / Q000401:mortality; D015996:Survival Rate
keywords: Aortic Valve Replacement; Aortic valve surgery; Cardiac surgery; Heart valve prothesis; Median sternotomy; Octogenarian