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Valve surgery in octogenarians.

A C Ralph-Edwards1, A G Robinson, R S Gordon

  • 1Toronto General Hospital, Toronto, Canada. aralph-edwards@torhosp.toronto.on.ca

The Canadian Journal of Cardiology
|October 16, 1999
PubMed
Summary
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Octogenarians undergoing valve operations, particularly aortic valve surgery, show favorable outcomes with low mortality and good intermediate survival. Mitral valve procedures in this age group had higher mortality rates.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Medicine
  • Cardiac Valve Interventions

Background:

  • Elderly patients (octogenarians) present unique challenges for cardiac valve surgery.
  • Outcomes for valve operations in patients aged 80 and above require careful evaluation.

Purpose of the Study:

  • To assess the outcomes of octogenarians undergoing various valve operations.
  • To evaluate perioperative mortality, survival rates, and functional status in this patient cohort.

Main Methods:

  • A review of 125 consecutive patients aged 80+ who underwent valve operations between 1990-1996.
  • Prospective follow-up of hospital survivors for a mean of 36.6 months.

Main Results:

  • Aortic valve operations (n=102) had lower in-hospital mortality (4%) compared to mitral valve procedures (n=18, 17%).

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  • Overall six-year actuarial survival was 71.6%.
  • Survivors demonstrated significant improvement in New York Heart Association functional class.

    • Conclusions:

    • Aortic valve surgery in carefully selected octogenarians offers low perioperative mortality and good intermediate-term survival.
    • Mitral valve procedures in octogenarians are associated with higher perioperative mortality.
    • Coronary artery disease should not be the sole contraindication for surgery in this age group.