Aortic valve surgery in the elderly patient: a retrospective review

Elderly patients are referred with increasing frequency for aortic valve replacement (AVR), due to the ageing of the population and to improved results of surgery. We retrospectively analysed the in-hospital and short-term (up to three years) results of AVR in 185 patients aged >or=75 years, operated on at our institution from January 2000 to December 2003. Follow-up was completed by a telephone interview during January 2005. Hospital mortality was 6.5% (12 patients). A non-elective operation (P=0.001), preoperative NYHA functional class >or=III (P=0.06), and chronic renal failure (P=0.02) were associated with increased operative mortality. Of note, age >or=80 years did not increase the surgical risk. The 4-year actuarial survival was 70.5%, the event-free survival was 60.6%, and almost all of the interviewed patients thought that they had benefited from the operation. Preoperative intubation, a NYHA class >or=III, and a non-elective operation were univariate predictors of a poorer outcome. Our data show that aortic valve replacement may be performed with low morbidity and mortality in the elderly patient (age >or=75 years), and that an age >or=80 years neither increases the surgical risk, nor significantly worsens the short-term outcome.