(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
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