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Primary valvular surgery in octogenarians: perioperative outcome
Frédéric Collart1, Horea Feier, Francois Kerbaul
1Department of Cardiac Surgery, Timone University Hospital, Marseille, France. fcollart@univ-aix.fr
The Journal of Heart Valve Disease
|March 29, 2005
Summary
Cardiac valve surgery in octogenarians is safe, with low mortality. Postoperative low cardiac output and gastrointestinal ischemia were identified as key risk factors for mortality in this elderly population.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Cardiac surgery in octogenarians is increasingly common.
- Routine procedures generally lead to improved functional capacity.
- This study evaluates outcomes and risk factors in elderly patients undergoing valve surgery.
Purpose of the Study:
- To assess operative mortality in octogenarians undergoing valvular surgery.
- To identify preoperative and postoperative risk factors associated with mortality.
- To evaluate the safety and efficacy of cardiac valve surgery in the elderly population.
Main Methods:
- Retrospective review of 200 consecutive patients (mean age 83) undergoing valvular surgery (1991-2002).
- Procedures included aortic valve replacement, mitral surgery, and combined aortic and mitral valve surgery.
- Analysis of preoperative risk factors and postoperative complications, with EuroSCORE assessment.
Main Results:
- Hospital mortality was 7%.
- No significant preoperative risk factors for mortality were identified.
- Postoperative complications included low cardiac output (16.0%), supraventricular arrhythmia (29.5%), and pulmonary complications (9.5%).
- Low cardiac output, gastrointestinal ischemia, and surgical re-exploration were significant mortality risk factors.
Conclusions:
- Valvular surgery in octogenarians is a safe procedure with low operative risk.
- The EuroSCORE may overestimate mortality in this patient group.
- Identifying and managing postoperative complications is crucial for improving outcomes.