[Late results after heart valve surgery in the elderly]

Heart valve surgery was performed in 133 patients over the age of 60 between 1976 and 1981. There were 54 men and 79 women. Their ages ranged from 60 to 74 years (mean age 64.3 years). In this study, 54 valve prostheses (15 porcine and 39 mechanical) in the aortic position, 79 prostheses (69 porcine and 10 mechanical) in the mitral position and 3 prostheses (3 porcine) in the tricuspid position were implanted in 121 patients. Fifteen patients (11.3%) died in the hospital. The hospital mortality was high in the cases of MVR (14.6%), MVR + TAP (12.5%) and emergency (50%). The mean follow-up was 37.2 months (range 4 to 129 months, total 367.3 patient-years). There were 10 late deaths (8.5%). Actuarial survival for hospital survivors at 5 years was 89.2 per cent. At follow-up, 95.8% of the surviving patients were in New York Heart Association functional class I or II. Valve-related complications were thromboembolism (2.0% pt/year), periprosthetic leak (1.7% pt/year), primary tissue failure (0.5% pt/year) and thrombosed valve (0.3% pt/year). Anticoagulant-related hemorrhage necessitating hospitalization occurred in 2 patients (1.0% pt/year). The freedom from all events at 5 years was 72.8 per cent. This study suggests that heart valve surgery in the elderly can be performed with an acceptable mortality. Advanced age alone should not be a contraindication to surgical management.