Literature DB >> 1452924

Aortic valve replacement in octogenarians with aortic stenosis: a case-control study.

M Olsson1, L Granström, D Lindblom, M Rosenqvist, L Rydén.   

Abstract

OBJECTIVES: This study was designed to compare the results of aortic valve replacement in patients greater than or equal to 80 years old with those in patients 65 to 75 years old.
BACKGROUND: Aortic valve replacement may be potentially more complicated and require the use of more resources when performed in octogenarians rather than in younger patients. Few hard data on this possibility are available.
METHODS: The study group comprises all 44 patients greater than or equal to 80 years old (mean age 82 years) who underwent aortic valve replacement at our institution between January 1981 and July 1989. A control group of 83 patients with a mean age of 70 years was matched with the study group for gender and approximate date of valve replacement. Before operation, 86% of the older patients versus 36% of the younger patients were in New York Heart Association functional class III or IV (p less than 0.001). Data were retrospectively collected from hospital records and a self-assessment telephone interview was conducted.
RESULTS: The early mortality rate was 14% in the older group versus 4% in the younger group (p = 0.045). The duration of respirator support, intensive care and the total duration of the hospital stay did not differ significantly between groups. The incidence of postoperative low cardiac output syndrome was higher in the older group (p = 0.049), but the incidence of late valve-related complications was similar in the two groups. The 2-year survival rate (including data on patients who died early) was 73% in the older group and 90% in the younger group (p = NS). Six months postoperatively all patients but one were in functional class I or II.
CONCLUSIONS: Although the patients greater than or equal to 80 years old had a poorer preoperative status than that of younger patients, aortic valve replacement in this group did not require more use of hospital resources and resulted in a clinical improvement comparable to that of younger patients.

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Mesh:

Year:  1992        PMID: 1452924     DOI: 10.1016/0735-1097(92)90444-r

Source DB:  PubMed          Journal:  J Am Coll Cardiol        ISSN: 0735-1097            Impact factor:   24.094


  10 in total

1.  To operate or not on elderly patients with aortic stenosis: the decision and its consequences.

Authors:  B J Bouma; R B van Den Brink; J H van Der Meulen; H A Verheul; E C Cheriex; H P Hamer; E Dekker; K I Lie; J G Tijssen
Journal:  Heart       Date:  1999-08       Impact factor: 5.994

2.  Early and mid-term results of isolated aortic valve replacement for aortic stenosis in octogenarians.

Authors:  Yutaka Koyama; Koshi Sawada; Yoshihiro Goto; Shinji Ogawa; Hiroshi Baba; Yasuhide Okawa
Journal:  Gen Thorac Cardiovasc Surg       Date:  2014-11-16

3.  End-of-life decision making: a qualitative study of elderly individuals.

Authors:  K E Rosenfeld; N S Wenger; M Kagawa-Singer
Journal:  J Gen Intern Med       Date:  2000-09       Impact factor: 5.128

Review 4.  Transcatheter aortic valve insertion (TAVI): a review.

Authors:  B Clayton; G Morgan-Hughes; C Roobottom
Journal:  Br J Radiol       Date:  2013-11-20       Impact factor: 3.039

5.  Variability in treatment advice for elderly patients with aortic stenosis: a nationwide survey in The Netherlands.

Authors:  B J Bouma; J H van der Meulen; R B van den Brink; A E Arnold; A Smidts; L H Teunter; K I Lie; J G Tijssen
Journal:  Heart       Date:  2001-02       Impact factor: 5.994

Review 6.  How should we manage symptomatic aortic stenosis in the patient who is 80 or older?

Authors:  D C Sprigings; J C Forfar
Journal:  Br Heart J       Date:  1995-11

7.  Early and late outcomes after isolated aortic valve replacement in octogenarians: an Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Study.

Authors:  Akshat Saxena; Chin-Leng Poh; Diem T Dinh; Christopher M Reid; Julian A Smith; Gilbert C Shardey; Andrew E Newcomb
Journal:  Eur J Cardiothorac Surg       Date:  2012-01       Impact factor: 4.191

8.  Surgery for aortic stenosis in severely symptomatic patients older than 80 years: experience in a single UK centre.

Authors:  T Gilbert; W Orr; A P Banning
Journal:  Heart       Date:  1999-08       Impact factor: 5.994

9.  Mass reduction and functional improvement of the left ventricle after aortic valve replacement for degenerative aortic stenosis.

Authors:  Sumin Shin; Pyo Won Park; Woo-Sik Han; Ki Ick Sung; Wook Sung Kim; Young Tak Lee
Journal:  Korean J Thorac Cardiovasc Surg       Date:  2011-12-07

10.  Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study.

Authors:  Pontus Andell; Xinjun Li; Andreas Martinsson; Charlotte Andersson; Martin Stagmo; Bengt Zöller; Kristina Sundquist; J Gustav Smith
Journal:  Heart       Date:  2017-04-21       Impact factor: 5.994

  10 in total

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