Aortic valve replacement in elderly patients with aortic stenosis

Area of Science:

• Cardiology
• Cardiac Surgery
• Geriatric Medicine

Background:

• Severe aortic stenosis is a common valvular heart disease in elderly populations.
• Aortic valve replacement (AVR) is the definitive treatment for symptomatic severe aortic stenosis.
• Concerns exist regarding the safety and long-term efficacy of AVR in the elderly.

Purpose of the Study:

• To evaluate the perioperative risk and long-term outcomes of AVR in elderly patients (>= 60 and >= 70 years).
• To compare survival rates and functional status between different age groups undergoing AVR.
• To identify factors influencing outcomes after AVR in older adults.

Main Methods:

• Retrospective analysis of 140 patients undergoing AVR over a 10-year period.
• Patients were stratified into two groups: 60-69 years (n=93) and >= 70 years (n=47).
• Outcomes assessed included early and late mortality, functional status (NYHA class), and cardiothoracic ratio.

Main Results:

• The proportion of patients > 70 years undergoing AVR increased significantly over the study period.
• Perioperative mortality was 3.6%, with 2-year and 5-year survival rates of 91% and 87% respectively.
• Survival and functional outcomes were similar between the 60-69 and >= 70 age groups, with 96% of survivors in NYHA class I or II.

Conclusions:

• Aortic valve replacement in elderly patients with severe aortic stenosis is associated with low mortality.
• Age is not a significant predictor of adverse outcomes following AVR.
• AVR offers good long-term functional improvement and survival benefits for elderly patients with severe aortic stenosis.