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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Valve replacement in octogenarians: arguments for an earlier surgical intervention
Cornelia Piper1, Detlev Hering, Georg Kleikamp
1Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstr. 11, D-32545 Bad Oeynhausen, Germany. cpiper@hdz-nrw.de
The Journal of Heart Valve Disease
|June 30, 2009
Summary
Aortic valve replacement (AVR) in octogenarians is safe and effective, with low mortality. Delaying AVR due to age or comorbidities can lead to worse outcomes and increased risks.
Area of Science:
- Cardiology
- Geriatric Medicine
- Cardiac Surgery
Background:
- Symptomatic aortic valve stenosis (AS) in octogenarians is often undertreated due to overestimated risks of aortic valve replacement (AVR).
- Delayed AVR in elderly patients with AS can lead to myocardial decompensation, increasing perioperative risks.
Purpose of the Study:
- To evaluate the safety and outcomes of AVR in octogenarians with symptomatic AS.
- To compare outcomes between octogenarians with and without chronic myocardial decompensation.
Main Methods:
- Prospective study of 83 octogenarians with isolated symptomatic AS (2003-2006).
- Patients were divided into Group A (with chronic myocardial decompensation) and Group B (without).
- All patients underwent AVR, with 28% also receiving coronary revascularization.
Main Results:
- 30-day mortality was 5.3% in Group A and 2.2% in Group B.
- Major postoperative complications were higher in Group A (26.3%) versus Group B (8.9%).
- Group B showed significantly more favorable cumulative survival rates at 24 and 46 months.
Conclusions:
- AVR in octogenarians is associated with low mortality and morbidity.
- AVR for symptomatic AS in octogenarians should not be postponed.
- Age should not be the sole determinant for AVR decisions; comorbidities should be considered.
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