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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Surgery for aortic stenosis in severely symptomatic patients older than 80 years: experience in a single UK centre

T Gilbert1, W Orr, A P Banning

  • 1Department of Cardiology, John Radcliffe Hospital, Oxford OX3 9DU, UK.

Heart (British Cardiac Society)
|July 20, 1999
PubMed

Insights

Aortic valve replacement (AVR) in patients over 80 carries significant surgical risk, but survivors experience substantial long-term benefits in health and independence.

Area of Science:

  • Cardiothoracic Surgery
  • Geriatric Cardiology
  • Valvular Heart Disease

Background:

  • Aortic valve replacement (AVR) is a critical intervention for severe aortic stenosis.
  • Evaluating surgical risk and long-term outcomes in elderly patients (over 80) is essential due to increased comorbidities.

Discussion:

  • This study assessed the surgical risk and long-term outcomes of 103 patients over 80 undergoing AVR.
  • Impaired renal function and peripheral vascular disease were identified as significant predictors of early mortality.
  • Prolonged ventilation (>24 hours) was associated with a high mortality rate (10/12 patients).

Key Insights:

  • Despite a significant operative risk (19/103 mortality), AVR in octogenarians can yield favorable long-term results.
  • The 50% actuarial survival was 62 months, with 92% of survivors achieving New York Heart Association (NYHA) class I or II functional status.
  • Successful AVR improves general health and social independence for elderly patients.

Outlook:

  • Further research could explore risk stratification models specific to octogenarian AVR patients.
  • Optimizing perioperative care may mitigate risks associated with prolonged ventilation and comorbidities.
  • Expanding access to AVR for carefully selected elderly patients can enhance quality of life.
Abstract

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