Aortic valve replacement for octogenarians: are small valves bad?
Ann Thorac Surg
; 66(3): 699-705; discussion 705-6, 1998 Sep.
Article
em En
| MEDLINE
| ID: mdl-9768918
ABSTRACT
BACKGROUND:
As the population ages, more octogenarians become candidates for aortic valve replacement. Many octogenarians, particularly women, have a small aortic annulus and there is uncertainty as to the optimal management of this situation in that age group.METHOD:
To examine this issue, we reviewed 248 octogenarians (mean age, 82.6 +/- 2.3 years; 58% men) who underwent primary isolated aortic valve replacement (n = 99), or aortic valve replacement and coronary revascularization (n = 149), between 1980 and 1995. Nineteen-millimeter valves were used in 26% of the patients.RESULTS:
In-hospital mortality was 8.9%, 5% for aortic valve replacement alone and 11.4% for aortic valve replacement and coronary revascularization. It was 12.5% for the 19-mm size valves compared with 7.7% for the bigger size valves (p = 0.24). Follow-up (mean interval, 4.4 years) demonstrated survival for all patients of 85%, 60%, and 30% and survival free from cardiovascular events of 80%, 45%, and 21% at 1, 5, and 10 postoperative years, respectively. Multivariate analysis identified triple-vessel disease and preoperative congestive heart failure as associated with increased risk for both in-hospital and late mortality (p < 0.05). Valve size did not influence late survival or event-free survival regardless of body surface area.CONCLUSIONS:
The use of small aortic valve prostheses in octogenarians does not adversely affect the incidence of early or late mortality or cardiac events.
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Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
/
Implante de Prótese de Valva Cardíaca
Idioma:
En
Ano de publicação:
1998
Tipo de documento:
Article