Cardiac valve replacement in patients over 75 years of age

The Thoracic and Cardiovascular Surgeon
J F TeplyA Starr

Abstract

Elderly patients with symptomatic cardiac valvular malfunction have a grave prognosis if managed medically but can be offered a reasonable chance for long-term survival and a good chance for improvement by replacement of the malfunctioning valve. A series of patients 75 years of age and older who underwent aortic valve replacement (31 patients) mitral valve replacement (9 patients), or combined valve replacement (on patient) has been reviewed. The overall operative mortality for aortic valve replacement was 23% (17% over the past 5 years) and the 5-year actuarial survival was 54 +/- 11%. The operative mortality for mitral replacement was 11% and the 5-year actuarial survival was 55 +/- 21%. The average hospital stay for survivors was 19 days after aortic valve replacement. Four patients have had embolic events since valve replacement, 3 after aortic and one after mitral valve replacement. The addition of coronary artery bypass surgery to the valve replacement procedure is becoming more frequent and may have contributed to improved operative survival. A literature review of reported clinical experience shows that the advancement of cardiac surgery has permitted a redefining of the group thought as "elderly", and that this group ...Continue Reading

Citations

Mar 5, 2004·American Heart Journal·Julien I E HoffmanRichard R Liberthson
Nov 1, 1987·Mayo Clinic Proceedings·J H O'KeefeD R Holmes
May 1, 1990·American Heart Journal·B Strauss, J F Marquis
Dec 1, 1987·The Annals of Thoracic Surgery·B M BlakemanB K Foy
Aug 1, 1987·Journal of the American College of Cardiology·S H RahimtoolaA M Hutter
Apr 26, 2011·Emergency Medicine Clinics of North America·Luna Ragsdale, Lauren Southerland
Aug 10, 2000·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·A C EisenhauerT C Piemonte
May 1, 1988·The Annals of Thoracic Surgery·F RobicsekJ J Gallagher

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