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Heart valve replacement in septuagenarians
D Lindblom1, U Lindblom, T Ivert
1Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden.
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1989
Summary
Mechanical heart valve replacement is safe for elderly patients (70-80 years). Long-term survival rates are comparable to younger patients, with low complication risks, avoiding future valve degeneration.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Elderly patients often present with complex cardiac conditions requiring intervention.
- Heart valve degeneration necessitates consideration of durable prosthetic options.
Purpose of the Study:
- To evaluate the safety and efficacy of Björk-Shiley mechanical heart valve replacement in patients aged 70-80 years.
- To assess long-term survival and complication rates in this elderly cohort.
Main Methods:
- A cohort of 208 patients (70-80 years) underwent heart valve replacement (aortic, mitral, or both) using Björk-Shiley valves.
- 100% follow-up over 744 patient-years with maintenance oral anticoagulant therapy.
Main Results:
- Early mortality was 9.6%, lower (3.9%) in elective aortic valve replacement for stenosis.
- Actuarial survival (excluding early mortality) was 79% at 5 years and 73% at 8 years.
- Age- and sex-adjusted survival normalized after one year, with an 87% 'cure' rate and low thromboembolism/bleeding rates.
Conclusions:
- Mechanical heart valve implantation with anticoagulation is a safe and effective treatment for elderly patients.
- This approach offers durable valve function, eliminating the need for re-replacement due to degeneration.