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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
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Aortic valve replacement in octogenarians with prior cardiac surgery
Tomasz A Timek1, Zaahir Turfe2, Robert L Hooker1
1Department of Cardiothoracic Surgery, Meijer Heart and Vascular Institute at Spectrum Health, Grand Rapids, Michigan.
The Annals of Thoracic Surgery
|September 9, 2014
Summary
Surgical aortic valve replacement (AVR) is a safe option for octogenarians with prior cardiac surgery, showing good mid-term survival. Age should not exclude these patients from AVR.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
- Cardiac Valve Interventions
Background:
- Transcatheter aortic valve implantation (TAVI) is an option for elderly patients with aortic stenosis and prior cardiac surgery.
- Outcomes of surgical aortic valve replacement (AVR) in very elderly patients with prior cardiac surgery remain largely unknown.
Purpose of the Study:
- To evaluate the perioperative and mid-term outcomes of surgical AVR in patients aged 80 years and older with a history of prior cardiac surgery.
Main Methods:
- Retrospective analysis of 61 patients (≥80 years) who underwent AVR after prior cardiac surgery, using the Society of Thoracic Surgeons (STS) Database.
- Follow-up mortality assessed via the Social Security Death Index.
Main Results:
- Perioperative mortality was low at 1.6%.
- One, three, five, and seven-year survival rates were 85%, 69%, 63%, and 43%, respectively.
- Concomitant coronary artery bypass grafting (CABG) and type of aortic prosthesis did not significantly impact survival.
Conclusions:
- Surgical AVR can be performed safely in selected octogenarians with prior cardiac surgery, demonstrating favorable mid-term outcomes.
- Age alone should not be an exclusion criterion for surgical AVR in this patient population.
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