Early and long-term survival after aortic valve replacement in septuagenarians and octogenarians with severe aortic stenosis

International Journal of Cardiology
Wen-hong DingMichael Y Henein

Abstract

To evaluate the predictors for mortality following aortic valve replacement (AVR) in elderly patients with aortic stenosis (AS). 112 consecutive elderly AS patients (aged 77+/-2 years) with AVR between 1998 and 2003 were studied. Clinical and echocardiographic data of LV function were recorded before and 46 months after AVR. Results were compared with 72 younger patients (aged 60+/-1 years). Outcome measures were 30-day and long-term all cause mortalities. Elderly patients had higher NYHA class, more frequent atrial fibrillation, coronary artery disease, emergency operation and use of bioprosthetic valves. They also had shorter E-wave deceleration time (DT) and larger left atria (p<0.05 for all). 30-day mortality was 12% vs 4% (Log Rank x(2)=3.02, p=0.08) and long term mortality was 18% vs 7% (Log Rank x(2)=4.38, p=0.04) in two groups respectively. Age was not related to mortality after adjustment for other variables. Among all variables, anemia (OR 4.20, CI: 1.02-6.86, p=0.04), cardiopulmonary bypass (CPB) time (OR 1.02, CI 1.01-1.04, p<0.01), significant prosthesis patient mismatch (PPM) (OR 5.43, CI 1.04-18.40, p<0.05) were associated with 30-day mortality in elderly patients. Their long-term mortality was related to CBP tim...Continue Reading

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Citations

Nov 4, 2010·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Marco De CarloA Sonia Petronio
May 28, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Albert H M van StratenMohamed A Soliman Hamad
May 16, 2012·International Journal of Cardiology·Hisato TakagiTakuya Umemoto
Mar 15, 2012·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Hasan JilaihawiRaj R Makkar
May 12, 2016·European Heart Journal Cardiovascular Imaging·Judith KramerYan Topilsky

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