| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 1997;96:3403-3408.)
© 1997 American Heart Association, Inc.
Articles |
Aortic Valve Replacement in Patients 80 Years of Age and Older
Survival and Cause of Death Based on 1100 Cases: Collective Results From the UK Heart Valve Registry
From the Cardiothoracic Department, Hammersmith Hospital, London, UK.
Correspondence to Prof K.M. Taylor, FRCS, Department of Cardiothoracic Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Rd, London W12 0NN, UK.
Background Aging of the population and advances in
preoperative and postoperative care are reflected in an increasing
number of patients 
80 years of age undergoing aortic valve
replacement (AVR) in the United Kingdom. The present study
presents data on postoperative 30-day mortality, actuarial
survival, and cause of death based on a large collective patient
population.
Methods and Results Data were extracted from the UK Heart
Valve Registry. From January 1986 to December 1995, 1100 patients 80
years of age underwent AVR and were reported to the registry. Six
hundred eleven patients (55.5%) were women. The mean follow-up time
was 38.9 months. The 30-day mortality was 6.6%. Of the 73 early
deaths, 42 were due to cardiac reasons. The actuarial survival was
89%, 79.3%, 68.7%, and 45.8% at 1, 3, 5, and 8 years, respectively.
After the first 30 postoperative days, 144 of the 205 deaths were due
to noncardiac reasons. Malignancy, stroke, and pneumonia were the most
common causes of late death. Bioprosthetic valves were
implanted in 969 patients (88%) and mechanical valves in 131 (12%)
patients. There was no difference in early mortality and actuarial
survival between the two groups (P>.05).
Conclusions The above results suggest that under the
selection criteria for AVR currently applied in the United Kingdom,
patients 80 years of age show a satisfactory early postoperative
outcome and moderate medium-term survival benefit.
Key Words: survival • mortality • valves
This article has been cited by other articles:
 |
|
 |
|
  N. Al-Attar, D. Himbert, F. Descoutures, B. Iung, R. Raffoul, D. Messika-Zeitoun, E. Brochet, F. Francis, H. Ibrahim, A. Vahanian, et al. Transcatheter Aortic Valve Implantation: Selection Strategy Is Crucial for Outcome. Ann. Thorac. Surg., June 1, 2009; 87(6): 1757 - 1763. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Ye, A. Cheung, S. V. Lichtenstein, L. A. Altwegg, D. R. Wong, R. G. Carere, C. R. Thompson, R. R. Moss, B. Munt, S. Pasupati, et al. Transapical transcatheter aortic valve implantation: 1-year outcome in 26 patients. J. Thorac. Cardiovasc. Surg., January 1, 2009; 137(1): 167 - 173. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. H. Thourani, R. Myung, P. Kilgo, K. Thompson, J. D. Puskas, O. M. Lattouf, W. A. Cooper, J. D. Vega, E. P. Chen, and R. A. Guyton Long-Term Outcomes After Isolated Aortic Valve Replacement in Octogenarians: A Modern Perspective Ann. Thorac. Surg., November 1, 2008; 86(5): 1458 - 1465. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Kojodjojo, N. Gohil, D. Barker, P. Youssefi, T.V. Salukhe, A. Choong, M. Koa-Wing, J. Bayliss, D.R. Hackett, and M.A. Khan Outcomes of elderly patients aged 80 and over with symptomatic, severe aortic stenosis: impact of patient's choice of refusing aortic valve replacement on survival QJM, July 1, 2008; 101(7): 567 - 573. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Vicchio, A. Della Corte, L. S. De Santo, M. De Feo, G. Caianiello, M. Scardone, and M. Cotrufo Tissue Versus Mechanical Prostheses: Quality of Life in Octogenarians Ann. Thorac. Surg., April 1, 2008; 85(4): 1290 - 1295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. de Vincentiis, A. B. Kunkl, S. Trimarchi, P. Gagliardotto, A. Frigiola, L. Menicanti, and M. Di Donato Aortic Valve Replacement in Octogenarians: Is Biologic Valve the Unique Solution? Ann. Thorac. Surg., April 1, 2008; 85(4): 1296 - 1301. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Silvay, J. G. Castillo, J. Chikwe, B. Flynn, and F. Filsoufi Cardiac Anesthesia and Surgery in Geriatric Patients Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2008; 12(1): 18 - 28. [Abstract] [PDF]
|
|
|
|
|
|
E. A. Grossi, C. F. Schwartz, P.-J. Yu, U. P. Jorde, G. A. Crooke, J. B. Grau, G. H. Ribakove, F. G. Baumann, P. Ursumanno, A. T. Culliford, et al. High-Risk Aortic Valve Replacement: Are the Outcomes as Bad as Predicted? Ann. Thorac. Surg., January 1, 2008; 85(1): 102 - 107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. S. Tjang, Y. van Hees, R. Korfer, D. E. Grobbee, and G. J.M.G. van der Heijden Predictors of mortality after aortic valve replacement Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 469 - 474. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Misfeld and H.-H. Sievers Heart valve macro- and microstructure Phil Trans R Soc B, August 29, 2007; 362(1484): 1421 - 1436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Webb, S. Pasupati, K. Humphries, C. Thompson, L. Altwegg, R. Moss, A. Sinhal, R. G. Carere, B. Munt, D. Ricci, et al. Percutaneous Transarterial Aortic Valve Replacement in Selected High-Risk Patients With Aortic Stenosis Circulation, August 14, 2007; 116(7): 755 - 763. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Melby, A. Zierer, S. P. Kaiser, T. J. Guthrie, J. D. Keune, R. B. Schuessler, M. K. Pasque, J. S. Lawton, N. Moazami, M. R. Moon, et al. Aortic Valve Replacement in Octogenarians: Risk Factors for Early and Late Mortality Ann. Thorac. Surg., May 1, 2007; 83(5): 1651 - 1657. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Barreiro, N. D. Patel, T. P. Fitton, J. A. Williams, P. N. Bonde, V. Chan, D. E. Alejo, V. L. Gott, and W. A. Baumgartner Aortic Valve Replacement and Concomitant Mitral Valve Regurgitation in the Elderly: Impact on Survival and Functional Outcome Circulation, August 30, 2005; 112(9_suppl): I-443 - I-447. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Pellikka, M. E. Sarano, R. A. Nishimura, J. F. Malouf, K. R. Bailey, C. G. Scott, M. E. Barnes, and A. J. Tajik Outcome of 622 Adults With Asymptomatic, Hemodynamically Significant Aortic Stenosis During Prolonged Follow-Up Circulation, June 21, 2005; 111(24): 3290 - 3295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Fish Percutaneous Heart Valve Replacement: Enthusiasm Tempered Circulation, October 5, 2004; 110(14): 1876 - 1878. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Kawachi, A. Nakashima, Y. Toshima, S. Kimura, and K. Arinaga Outcome of Cardiac and Thoracic Aortic Operation in Patients Over 80 Years Old Asian Cardiovasc Thorac Ann, March 1, 2002; 10(1): 12 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. C. Astor, R. G. Kaczmarek, B. Hefflin, and W. R. Daley Mortality after aortic valve replacement: results from a nationally representative database Ann. Thorac. Surg., December 1, 2000; 70(6): 1939 - 1945. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Knott-Craig, R. C. Elkins, K. Santangelo, C. McCue, and M. M. Lane Aortic valve replacement: comparison of late survival between autografts and homografts Ann. Thorac. Surg., May 1, 2000; 69(5): 1327 - 1331. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Asimakopoulos and K. M. Taylor Octogenarians and cardiac surgery Ann. Thorac. Surg., January 1, 2000; 69(1): 317 - 318. [Full Text] [PDF]
|
|
|
|
 |
|
 D C SPRIGINGS Cardiac surgery in the elderly: a cardiologist's perspective Heart, August 1, 1999; 82(2): 123 - 124. [Full Text] [PDF]
|
|
|
|
|
|
T Gilbert, W Orr, and A P Banning Surgery for aortic stenosis in severely symptomatic patients older than 80 years: experience in a single UK centre Heart, August 1, 1999; 82(2): 138 - 142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Peterseim, Y.-Y. Cen, S. Cheruvu, K. Landolfo, T. M. Bashore, J. E. Lowe, W. G. Wolfe, and D. D. Glower LONG-TERM OUTCOME AFTER BIOLOGIC VERSUS MECHANICAL AORTIC VALVE REPLACEMENT IN 841 PATIENTS J. Thorac. Cardiovasc. Surg., May 1, 1999; 117(5): 890 - 897. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. R. Dalrymple-Hay, A. Alzetani, S. Aboel-Nazar, M. Haw, S. Livesey, and J. Monro Cardiac surgery in the elderly Eur. J. Cardiothorac. Surg., January 1, 1999; 15(1): 61 - 66. [Abstract] [Full Text] [PDF]
|
|