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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Aortic valve replacement in octogenarians: identification of high-risk patients

Ines Florath1, Alexander Albert, Andreas Boening

  • 1Heart Institute Lahr/Baden, Hohbergweg 2, D-77933 Lahr, Germany. ines.florath@mediclin.de

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|February 2, 2010
PubMed

Insights

Surgical aortic valve replacement (AVR) is safe for most octogenarians. High-risk patients, identified by specific factors, have similar mortality rates to transcatheter aortic valve interventions.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Cardiology
  • Interventional Cardiology

Background:

  • Surgical aortic valve replacement (AVR) is a critical intervention for symptomatic aortic stenosis in octogenarians.
  • Advances in transcatheter valve therapies necessitate clear patient selection criteria for surgical AVR.

Purpose of the Study:

  • To identify high-risk octogenarians undergoing surgical AVR.
  • To define patient selection criteria for AVR in the elderly population.

Main Methods:

  • A retrospective analysis of 493 octogenarians who underwent AVR between 1996 and 2006.
  • Multivariable logistic regression was used to determine risk factors for 6-month mortality.

Main Results:

  • The 6-month mortality rate after AVR was 15.2%.
  • Independent risk factors for mortality included age >84 years, ejection fraction <60%, BMI <24, elevated creatinine, and high blood glucose.
  • High-risk groups (e.g., age >84 with EF <60%) experienced 28% 6-month mortality.

Conclusions:

  • Surgical AVR is generally safe and effective in octogenarians.
  • High-risk patients identified by STS score >10, EuroScore >20, or specific clinical factors (age, EF, BMI) show comparable mortality to transcatheter aortic valve interventions.
Abstract

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