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Aortic valve replacement with and without concomitant coronary artery bypass surgery in the elderly: risk factors

L I Thulin1, J L Sjögren

  • 1Department of Cardiothoracic Surgery, Lund University Hospital, SE-221 85 Lund, Sweden. lars_thulin@hotmail.com

Croatian Medical Journal
|November 7, 2000
PubMed

Insights

Aortic valve replacement (AVR) in elderly patients (>75 years) shows excellent surgical outcomes. Concomitant coronary artery bypass grafting (CABG) did not negatively impact long-term survival in this population.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Geriatric Medicine

Background:

  • Elderly patients (>75 years) undergoing aortic valve replacement (AVR) frequently have significant coronary artery lesions.
  • The benefit of concurrent coronary artery bypass grafting (CABG) with AVR in this age group remains debated.

Purpose of the Study:

  • To evaluate the long-term survival outcomes of elderly patients undergoing AVR with or without concomitant CABG.
  • To determine if concomitant CABG influences surgical outcomes in elderly AVR patients.

Main Methods:

  • Retrospective analysis of 219 patients aged 75+ undergoing AVR between 1990-1993.
  • Patients were divided into AVR alone (n=121) and AVR with CABG (n=98) groups.
  • Long-term survival was assessed using Kaplan-Meier analysis and Cox-Mantel log-rank tests.

Main Results:

  • Early mortality was 0.8% for AVR and 4.1% for AVR+CABG.
  • Overall actuarial survival at 52 months was 77.7%.
  • Mechanical valve implantation in the AVR group was associated with significantly longer survival; concomitant CABG did not significantly affect long-term survival.

Conclusions:

  • Aortic valve replacement in the elderly is a safe procedure with favorable surgical results.
  • Concomitant coronary artery bypass grafting is not identified as a predictor of poor long-term surgical outcome in elderly patients undergoing AVR.
Abstract

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