Article

Heart valve surgery in octogenarians: Operative and long-term results

Department of Surgery (2), Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
Heart and Vessels (Impact Factor: 2.07). 09/2010; 25(6):522-8. DOI: 10.1007/s00380-010-0009-0
Source: PubMed

ABSTRACT

This study was performed to evaluate surgical outcomes in octogenarian patients undergoing valve surgery. Sixty patients (mean age 82.3 ± 1.9 years) who underwent valve surgery were reviewed. Aortic valve disease was found in 65% of the patients. Preoperatively, 20% of the patients were in NYHA class IV. An urgent operation and concomitant coronary artery bypass grafting were performed in ten patients each. A bioprosthetic valve was exclusively used for valve replacement except in two patients. Mitral valve repair was done in seven patients. Operative mortality was 13.3% for the period. No risk factors for operative mortality were detected by multivariate analysis; however, urgent operation, preoperative NYHA class IV, preoperative renal dysfunction, perioperative use of an intra-aortic balloon pumping, and prolonged cardiopulmonary bypass time had significant effects on operative mortality. The actuarial survival rate at 1 and 3 years after surgery was 82.6 and 71.5%, respectively, and 97.6% of late survivors reported that their activity level was equal to or better than the preoperative level. Valve surgery can be performed in octogenarian patients with acceptable mortality, good long-term results, and good quality of life. Early referral to surgery should be important to obtain a better postoperative outcome.

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    • "As we observed, postponing the time of the intervention increases PH before surgery, with the possibility of an irreversible component that will lead to P-PH. On the other hand, patients are exposed to a higher surgical risk because surgical mortality increases as previous sPAP increases (2–3 % rates of mortality with no PH or mild PH Vs. 8–12 % rates with moderate to severe PH)[32,33]. The delay of the surgery involves a greater number of cases with mitral and tricuspid valve surgery. "
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