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Aortic valve replacement in the elderly

P N Ruygrok1, B G Barratt-Boyes, T M Agnew

  • 1Department of Cardiology, Green Lane Hospital, Auckland, New Zealand.

The Journal of Heart Valve Disease
|September 1, 1993
PubMed
Summary
This summary is machine-generated.

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Aortic valve replacement is safe for elderly patients (70+ years), showing similar hospital mortality to younger groups. Long-term survival and quality of life are significantly improved in elderly patients after this procedure.

Area of Science:

  • Cardiovascular Surgery
  • Geriatric Medicine
  • Cardiac Valve Disease

Background:

  • Aortic valve disease significantly impacts elderly patients' quality of life and survival.
  • While aortic valve replacement (AVR) is established, outcomes in the elderly (70+ years) require careful evaluation.
  • Previous data suggested higher mortality and morbidity in elderly patients undergoing AVR.

Purpose of the Study:

  • To compare hospital mortality and morbidity between elderly (70+) and younger (60-69) patients undergoing isolated AVR or AVR with coronary artery bypass surgery (CABG).
  • To assess the long-term survival and quality of life in elderly patients after AVR or AVR+CABG.

Main Methods:

  • Retrospective analysis of 183 elderly patients (70+ years) and 340 younger patients (60-69) undergoing AVR or AVR+CABG between 1980-1989.

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  • Comparison of hospital mortality, morbidity (including stroke rate), and long-term outcomes (survival, angina, heart failure symptoms, quality of life).

    • Main Results:

    • No significant difference in hospital mortality between elderly (4.4%) and younger (4.1%) groups.
    • Elderly patients had a significantly higher perioperative stroke rate (4.4% vs 1.5%, p < 0.05).
    • Five-year actuarial survival for elderly patients was 81%, exceeding the age- and sex-matched general population (73%).
    • Of survivors, 80% were free of angina and 73% had no significant heart failure symptoms.

    Conclusions:

    • Aortic valve replacement is a viable and effective treatment for elderly patients (70+ years), with comparable hospital mortality to younger patients.
    • While stroke risk is higher in the elderly, long-term survival and symptom relief are substantial, leading to improved quality of life.
    • AVR in the elderly is associated with favorable long-term outcomes, justifying its consideration in this population.