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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Surgical Aortic Valve Replacement in the Elderly: It Is Worth It!
Joseph Nader1, Omar Zainulabdin2, Mohamed Marzouk2
1Department of Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada; Department of Cardiac Surgery, Amiens University Hospital, Amiens, France.
Seminars in Thoracic and Cardiovascular Surgery
|March 10, 2021
Summary
Surgical aortic valve replacement (SAVR) in octogenarians offers effective long-term survival and good quality of life. This study shows SAVR is a viable treatment option for elderly patients with aortic valve disease.
Area of Science:
- Cardiology
- Cardiac Surgery
- Geriatric Medicine
Background:
- Octogenarians with aortic valve disease face significant mortality risks.
- Surgical aortic valve replacement (SAVR) is a complex procedure in this age group.
- Long-term survival and quality of life outcomes after SAVR in octogenarians require further evaluation.
Purpose of the Study:
- To assess the long-term survival and health-related quality of life in octogenarians following SAVR.
- To identify predictors of mortality in this patient cohort.
- To evaluate the durability and effectiveness of SAVR in elderly individuals.
Main Methods:
- Retrospective observational study including 909 octogenarians undergoing SAVR between 2005 and 2011.
- Data collection included preoperative factors, early postoperative course, and long-term follow-up up to July 2018.
- Survival was analyzed, and quality of life was assessed using the Short-Form 12 (SF-12) questionnaire.
Main Results:
- The overall cohort had a median age of 82 years; 7.8% experienced early in-hospital mortality.
- Ten-year survival rates were 28% for the overall cohort, with no significant difference between isolated or combined SAVR.
- Patients with Euroscore <8% had significantly higher survival. Older age, diabetes, myocardial infarction, atrial fibrillation, and renal failure predicted mortality. SF-12 scores were comparable to the general population.
Conclusions:
- SAVR is an effective treatment for octogenarians with aortic valve disease, leading to increased life expectancy.
- The procedure confers a lasting quality of life and demonstrates excellent valve durability in this elderly population.
- Risk stratification using scores like Euroscore is crucial for predicting outcomes in octogenarian SAVR patients.
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