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[Heart valve replacement in patients over 60].

F A Flachskampf, H Lambertz, D Wohltmann

    Deutsche Medizinische Wochenschrift (1946)
    |September 5, 1986
    PubMed
    Summary

    Valve replacement surgery in patients over 60 years old shows low mortality and good outcomes. Delaying surgery for elderly patients with heart valve disease increases risks and worsens results.

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    [A patient with aortic valve stenosis and severe obstruction of the left ventricular outflow tract: a diagnostic challenge].

    Deutsche medizinische Wochenschrift (1946)·2010

    Area of Science:

    • Cardiovascular Surgery
    • Geriatric Cardiology
    • Valvular Heart Disease

    Context:

    • Between 1976 and 1984, 182 patients aged 60+ underwent invasive valve examination and replacement.
    • 34 patients (19%) were over 70 years old.
    • Simultaneous aortocoronary bypass did not increase surgical risk.

    Purpose:

    • To evaluate the outcomes of valve replacement surgery in elderly patients (60+ years).
    • To assess the impact of age on mortality and functional results after valve replacement.
    • To determine the optimal timing for valve replacement in older adults.

    Summary:

    • Hospital mortality rates were 2% (aortic), 4% (mitral), and 8% (double valve replacement).
    • Overall early mortality was 3.4% for 60-70 year olds and 6% for those over 70.

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  • Follow-up (23 months) showed 12% mortality, with only 4% experiencing clinical deterioration.
  • Impact:

    • Elderly patients (>70) and those with NYHA class IV symptoms had higher mortality and poorer functional outcomes.
    • Preoperative data did not significantly correlate with surgical results.
    • Indications for valve replacement in the elderly should not be more restrictive than in younger patients; delaying surgery increases mortality risk.