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Related Experiment Videos

Aortic valve selection in the elderly patient.

A M Borkon1, L M Soule, K L Baughman

  • 1Division of Cardiac Surgery and Cardiology, Johns Hopkins Hospital, Baltimore, MD.

The Annals of Thoracic Surgery
|September 1, 1988
PubMed
Summary
This summary is machine-generated.

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For patients over 70 undergoing aortic valve replacement, bioprosthetic valves show fewer complications than mechanical valves, particularly reducing hemorrhage risk. This favors bioprosthetic valve selection in this age group.

Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science
  • Geriatric Medicine

Background:

  • Aortic valve replacement is a common procedure in elderly patients.
  • Mechanical and bioprosthetic valves have different long-term performance profiles.
  • Optimal valve selection impacts patient survival and morbidity.

Purpose of the Study:

  • To compare the long-term performance of mechanical versus bioprosthetic heart valves.
  • To determine the influence of valve choice on patient survival and valve-related complications.
  • To identify risk factors for mortality in elderly patients undergoing aortic valve replacement.

Main Methods:

  • Analysis of 141 patients over 70 years old who underwent isolated aortic valve replacement between 1970 and 1985.

Related Experiment Videos

  • Comparative long-term follow-up (491 patient-years) of mechanical (N=68) and bioprosthetic (N=73) valve recipients.
  • Assessment of hospital mortality, patient survival, and valve-related morbidity.

    • Main Results:

    • Hospital mortality was similar (18% mechanical vs. 19% bioprosthetic).
    • 5-year survival was comparable (61% mechanical vs. 67% bioprosthetic).
    • Bioprosthetic valve recipients had fewer overall valve-related complications (10.7%/year vs. 17.6%/year) and significantly less anticoagulant-related hemorrhage (2.3%/year vs. 9.2%/year).

    Conclusions:

    • Bioprosthetic heart valves are favored for patients over 70 due to reduced valve-related complications and hemorrhage risk.
    • Male sex and urgent operation were independent risk factors for hospital mortality.
    • Atrial fibrillation increased valve-related mortality, but no structural valve failure or reoperations were noted.