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Is aortic valve replacement with bileaflet prostheses still contraindicated in the elderly?
Marisa De Feo1, Attilio Renzulli, Mariano Vicchio
1Department of Cardiothoracic and Respiratory Sciences, V. Monaldi Hospital, Second University of Naples, Italy.
Gerontology
|October 24, 2002
Summary
Elderly patients undergoing aortic valve replacement with bileaflet prostheses show excellent outcomes. Bileaflet prostheses are safe and effective for older adults, with low complication rates.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
- Biomaterials in Medicine
Background:
- Increased life expectancy leads to more elderly patients requiring aortic valve replacement.
- Aortic valve disease is prevalent in the aged population.
- Optimal prosthetic choice for elderly patients remains a clinical debate, focusing on anticoagulation risks.
Purpose of the Study:
- To review clinical outcomes of isolated aortic valve replacement using bileaflet prostheses in patients over 70.
- To compare these outcomes with a younger cohort (<50 years) who received mechanical devices.
Main Methods:
- Retrospective comparison of 118 elderly (Group A) and 122 young (Group B) patients undergoing isolated aortic valve replacement.
- Exclusion criteria included concomitant cardiac conditions.
- Comparison of mortality, complications, and anticoagulation status (INR).
Main Results:
- Hospital mortality was higher in the elderly group (9.3%) versus the young group (2.45%).
- 12-year survival was significantly lower in elderly patients (69.6%) compared to younger patients (94.4%).
- No significant differences in valve-related or anticoagulation-related complication rates were observed.
Conclusions:
- Bileaflet prostheses yield excellent clinical results in elderly patients undergoing aortic valve replacement.
- These prostheses offer a low risk of reoperation and anticoagulation complications.
- Advanced age should not preclude the use of bileaflet prostheses for aortic valve disease.