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[Cardiac valve replacement in the elderly].

Y Misawa1, T Hasegewa, M Kato

  • 1Department of Thoracic and Cardiovascular Surgery, Jichi Medical School.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|October 1, 1992
PubMed
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Cardiac valve replacement in elderly patients over 60 shows acceptable mortality and excellent functional improvement. This study highlights successful outcomes for older adults undergoing heart valve surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Geriatric Medicine

Background:

  • Cardiac valve replacement is a common procedure.
  • Elderly patients present unique challenges for cardiac surgery.
  • Assessing outcomes in older adults is crucial for surgical decision-making.

Purpose of the Study:

  • To evaluate the safety and efficacy of cardiac valve replacement in patients over 60 years of age.
  • To compare outcomes in elderly patients with a younger cohort.
  • To assess functional improvement and survival rates post-procedure.

Main Methods:

  • Retrospective analysis of 71 elderly patients (>=60 years) and 231 younger patients undergoing cardiac valve replacement between 1980-1990.
  • Detailed data collection on valve types (mechanical vs. bioprosthetic), concomitant procedures, preoperative functional status (NYHA Class), early mortality, and long-term survival.

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  • Follow-up period averaged 42 months.

    • Main Results:

    • Elderly group: 11% early mortality, 88% 5-year and 74% 10-year actuarial survival. 85.7% achieved excellent functional improvement (NYHA Class I/II).
    • Younger group: 3.0% early mortality, 95% 5-year and 86% 10-year actuarial survival. 91.3% achieved excellent functional improvement.
    • Majority of elderly patients (88.7%) were NYHA Class III/IV preoperatively.

    Conclusions:

    • Cardiac valve replacement in elderly patients can be performed with acceptable early mortality.
    • Significant and excellent functional improvement is achievable in older adults post-surgery.
    • The findings support the consideration of cardiac valve replacement for selected elderly patients.