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Aortic valve replacement in the over seventy age group
The Journal of Cardiovascular Surgery
|July 1, 1981
Summary
Aortic valve replacement is safe for patients over seventy, significantly improving survival rates and quality of life. Cold cardioplegia reduced hospital mortality from 14% to 5% in this elderly cohort.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Cardiac Valve Interventions
Background:
- Aortic valve replacement is a critical procedure for severe aortic stenosis.
- Elderly patients (septagenarians) present unique challenges for cardiac surgery.
- Outcomes in this age group require careful evaluation.
Purpose of the Study:
- To assess the safety and efficacy of aortic valve replacement in patients over seventy years old.
- To evaluate the impact of myocardial protection techniques on surgical outcomes.
- To determine long-term survival and functional status post-procedure.
Main Methods:
- Retrospective analysis of 50 patients aged 70+ undergoing aortic valve replacement between 1970-1979.
- Comparison of mortality rates before and after the introduction of cold cardioplegia.
- Actuarial survival analysis and assessment of New York Heart Association functional class.
Main Results:
- Overall hospital mortality was 14%, reduced to 5% after implementing cold cardioplegia.
- Predicted 5-year survival rate is 60%.
- Only 5% of survivors remained in functional class III or IV, indicating significant functional improvement.
Conclusions:
- Aortic valve replacement is a safe and effective procedure for septagenarians.
- The use of cold cardioplegia significantly enhances myocardial protection and reduces mortality.
- The surgery leads to improved longevity and enhanced quality of life in elderly patients.