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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Short- and mid-term results for aortic valve replacement in octogenarians
Manuel Carnero-Alcázar1, Fernando Reguillo-Lacruz, Ali Alswies
1Department of Cardiac Surgery, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
Interactive Cardiovascular and Thoracic Surgery
|January 27, 2010
Summary
Conventional open aortic valve replacement (AVR) shows good short- and mid-term results for degenerative aortic stenosis in patients over 80 years old. This study identified key predictors of mortality and major adverse cardio and cerebrovascular events (MACCEs) in this age group.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
- Valvular Heart Disease
Background:
- Increasing population over 80 years requiring surgery for degenerative aortic stenosis.
- Need for comparative analysis of surgical outcomes in octogenarians versus younger patients.
- Limited data on mid-term results for conventional aortic valve replacement (AVR) in the elderly.
Purpose of the Study:
- To compare short- and mid-term outcomes of conventional AVR for degenerative aortic stenosis in patients aged 80 years and older versus those younger than 80.
- To identify independent predictors of in-hospital mortality, late mortality, and major adverse cardio and cerebrovascular events (MACCEs) in octogenarians undergoing AVR.
Main Methods:
- Retrospective analysis of 451 patients undergoing conventional AVR for calcific-degenerative aortic stenosis between April 2004 and December 2008.
- Patients were divided into two groups: <80 years and >=80 years.
- Multivariable analysis was used to determine predictors of mortality and MACCEs during postoperative and follow-up periods.
Main Results:
- In-hospital mortality predictors included previous cardiac surgery, renal failure, concomitant coronary artery bypass grafting (CABG), female sex, and severe pulmonary hypertension.
- Late mortality predictors were age >=80 years, high blood pressure (HBP), and peripheral arterial disease (PAD).
- Predictors for MACCEs included renal failure, severe pulmonary hypertension, and concomitant CABG postoperatively, and diabetes mellitus and PAD during follow-up.
Conclusions:
- Conventional open AVR provides favorable early- and mid-term outcomes for octogenarians with degenerative aortic stenosis.
- Identifying and managing risk factors such as renal failure, HBP, PAD, and pulmonary hypertension is crucial for improving outcomes in older patients.
- The study highlights the safety and efficacy of AVR in the elderly population, supporting its consideration for suitable candidates.
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