Objectives: We analyzed our results long term in patients over 80 years with severe aortic stenosis who received a replacement of aortic valve alone or combined with coronary surgery.
Methods: Between January 2000 through May 2010, 173 older patients (> 70 years old) underwent cardiac surgery. Thirty-nine percent (67 patients) were more than 80 years old. Among those patients, forty-nine percent (33 patients) underwent aortic valve replacement alone or in combination with coronary artery bypass (43%, 29 patients). Follow-up patients were obtained in our hospital data and general practitioner.
Results: Mean age was 83,4 ± 2,8 (range 80-92) and 55,5% were female. Seven patients (10%) were with poor left ventricular function, defined as a low ejection fraction under 40 percent. Mean aortic valve area and gradient were 0,7 ± 0,2 cm2 and 43,3 ± 15,1 mmHg respectively. Mean ejection fraction was 58,6 ± 10,7 %.The mean logistic EUROSCORE were 14,1± 8,5 (range 7 – 50,7). Mean cross aortic clamping and cardiopulmonary bypass time were 58,5 ± 20,3 and 97,1 ± 32,0 minutes respectively. Length ICU stays was 6,9 ± 8,5 days with hospital stays averaged 24,2 ± 22,9 days. Six patients (8,9%) were death during hospital stay which represent 30-day mortality. NYHA classification before surgery was 67,2% and 19,4% for stage III and IV and 61,2% and 25,4% for stage I and II after surgery. Actuarial 5 and 10 years survival were 70,5% and 40% respectively.
Conclusions: Patients aged more than 80 years old who undergo aortic valve replacement can be performed with good mortality and acceptable long-term survival. Despite the increased morbidity, octogenarians should not be denied to cardiac surgery.
Long-term outcome of aortic valve replacement in octogenarians with high risk mortalityConstantin Stefanidis, Ahmed Sanoussi, Hélène Demanet, Franck Deuvaert, Pierre Wauthy
CHU Brugmann |