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Bioprosthetic valve replacement in the elderly
G Helft1, X Tabone, J L Georges
1Clinique Cardiologique, l'Hôpital Necker, Paris, France.
European Heart Journal
|April 1, 1995
Summary
Bioprosthetic valve replacement in patients over 65 shows good long-term survival. While valve deterioration is low, non-valve related mortality is significant, emphasizing comprehensive patient care.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomedical Engineering
Background:
- Bioprosthetic heart valves are widely used for valve replacement surgery.
- Long-term outcomes in elderly patients undergoing these procedures require ongoing evaluation.
Purpose of the Study:
- To assess the mid-term efficacy and safety of bioprosthetic valve replacement in patients older than 65 years.
- To evaluate valve-related complications, reoperation rates, and overall survival.
Main Methods:
- Retrospective analysis of 110 patients (mean age 73.4 years) who underwent bioprosthetic valve replacement (aortic, mitral, or both) between 1979 and 1985.
- Follow-up averaged 75 months, with actuarial survival rates calculated.
- Valve-related complications, reoperations, and mortality causes were documented.
Main Results:
- Actuarial survival was 79.4% at 5 years and 55.2% at 10 years.
- Low rates of primary structural deterioration (0.9%/patient-year) and reoperation mortality (12.5%) were observed.
- Non-valve related mortality accounted for 51.4% of deaths; severe bleeding occurred in 5.4% of patients on anticoagulants.
Conclusions:
- Bioprosthetic valve replacement in elderly patients offers favorable mid-term survival with a low incidence of structural deterioration.
- Mortality is predominantly driven by non-valve related causes, highlighting the importance of managing comorbidities in this population.
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