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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Quality of life after aortic valve replacement at the age of >80 years

T M Sundt1, M S Bailey, M R Moon

  • 1Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.

Circulation
|November 18, 2000
PubMed

Insights

Aortic valve replacement in patients over 80 offers excellent functional outcomes and acceptable operative risks. Surgery is recommended for the elderly, as age alone should not be a barrier to treatment.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Cardiac Surgery

Background:

  • Optimal management of aortic valve disease in elderly patients (>80 years) requires balancing functional outcomes, operative risks, and long-term survival.
  • Aortic valve disease presents unique challenges in the elderly population, necessitating careful consideration of treatment strategies.

Purpose of the Study:

  • To evaluate the functional outcomes, operative risks, and survival rates of patients aged 80 and older undergoing aortic valve replacement.
  • To determine the predictors of operative and late mortality in this elderly cohort.

Main Methods:

  • Retrospective analysis of 133 patients (aged 80-91 years) who underwent aortic valve replacement between 1993 and 1998.
  • Data collection included demographics, comorbidities, operative details, mortality, length of stay, and long-term follow-up (98% complete).
  • Multivariable analysis was used to identify risk factors for operative and late mortality. Quality of life was assessed using the Medical Outcomes Study Short Form-36.

Main Results:

  • Operative (30-day) mortality was 11%. Risk factors for operative death included urgent/emergent surgery, aortic insufficiency, and perioperative stroke or renal dysfunction.
  • Actuarial survival rates at 1 and 5 years were 80% and 55%, respectively. Predictors of late mortality included stroke, chronic obstructive pulmonary disease, aortic stenosis, and postoperative renal dysfunction.
  • For long-term survivors, New York Heart Association functional class improved from 3.1 to 1.7. Quality of life was comparable to the general elderly population.

Conclusions:

  • Aortic valve replacement in patients over 80 yields excellent functional outcomes, acceptable operative risks, and good late survival rates.
  • Age alone should not preclude elderly patients from undergoing aortic valve replacement.
  • The study supports surgical intervention for aortic valve disease in the elderly, emphasizing improved quality of life and survival benefits.
Abstract

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