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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Long-term survival of the very elderly undergoing aortic valve surgery

Donald S Likosky1, Meredith J Sorensen, Lawrence J Dacey

  • 1Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, NH, USA. donald.likosky@dartmouth.edu

Circulation
|September 16, 2009
PubMed

Insights

Survivorship after aortic valve replacement (AVR) and AVR with coronary artery bypass graft (CABG) surgery is favorable for octogenarians. More than half of patients over 80 survive over 6 years, with CABG not negatively impacting survival.

Area of Science:

  • Cardiology
  • Geriatric Surgery
  • Outcomes Research

Background:

  • An increasing number of elderly individuals are undergoing aortic valve procedures.
  • This study focuses on the short- and long-term survival rates within this specific patient demographic.

Purpose of the Study:

  • To evaluate the survivorship of very elderly patients undergoing aortic valve surgery.
  • To compare outcomes between isolated aortic valve replacement (AVR) and AVR with concomitant coronary artery bypass graft (CABG) surgery in patients aged 80 and older.

Main Methods:

  • A cohort study included 7584 patients undergoing open aortic valve surgery between 1987 and 2006.
  • Patient records were analyzed and linked to the Social Security Administration's Death Master File for survivorship data.
  • Survivorship was stratified by age groups (<80, 80-84, >=85 years) and procedure type (AVR vs. AVR + CABG).

Main Results:

  • Over 39,835 person-years of follow-up, 2877 deaths occurred.
  • Median survivorship for isolated AVR was 11.5 years (<80), 6.8 years (80-84), and 6.2 years (>=85).
  • Median survivorship for AVR + CABG was 9.4 years (<80), 6.8 years (80-84), and 7.1 years (>=85), with age significantly impacting survival (P<0.001).

Conclusions:

  • Survivorship among octogenarians undergoing aortic valve procedures is favorable, with over half surviving more than 6 years.
  • Concomitant CABG surgery does not appear to diminish median survivorship in patients over 80 years of age.
  • The findings suggest that advanced age alone should not be a contraindication for these procedures.
Abstract

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