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Severe aortic stenosis in octogenarians: is operation an acceptable alternative?
P Deleuze1, D Y Loisance, F Besnainou
1Service de Chirurgie Thoracique et Cardiovasculaire, CHU. Henri Mondor, Créteil, France.
The Annals of Thoracic Surgery
|August 1, 1990
Summary
Severe calcific aortic stenosis surgery in octogenarians carries high early risk but offers good long-term survival. Early intervention before heart function declines improves outcomes for elderly patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Severe calcific aortic stenosis (CAS) significantly impacts elderly patients.
- Surgical intervention is often necessary but carries substantial risks in octogenarians.
Purpose of the Study:
- To evaluate the outcomes of aortic valve replacement in patients over 80 years of age.
- To identify factors influencing early and late mortality and morbidity.
Main Methods:
- Retrospective analysis of 60 patients aged over 80 undergoing aortic valve replacement with bioprosthesis between 1981 and 1989.
- Assessment of preoperative functional class, left ventricular function, and operative details.
- Evaluation of early mortality, hospital morbidity, and long-term survival.
Main Results:
- One-month mortality was 28%, primarily due to cardiac and pulmonary complications.
- Hospital morbidity was 68%, with a mean hospitalization of 15 days.
- Long-term survival was 65% at 1 year and 61% at 5 years, with good functional recovery in survivors.
- Impaired left ventricular function (ejection fraction < 0.40) was associated with higher early mortality (40%).
Conclusions:
- Despite high operative risk, aortic valve replacement in octogenarians can provide good long-term quality of life.
- Early surgical intervention before significant cardiac dysfunction is crucial for improving outcomes in this age group.