Reconstructive aortic valve surgery in the elderly: Techniques and outcomes
The aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more. Between November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or mo...
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| Published in: | The Journal of thoracic and cardiovascular surgery Vol. 155; no. 4; pp. 1414 - 1420 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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01-04-2018
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| Abstract | The aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more.
Between November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or more (mean, 78 ± 3; range, 75-88 years), including 17 patients operated on an emergency basis because of acute aortic dissection. None/trivial, mild, moderate, and severe insufficiency grades were presented in 9, 23, 27, and 41 patients, respectively. The surgery comprised root repair, cusp repair, and a combination of both in 45, 16, and 39 patients, respectively.
Early (30-day) mortality and the rate of permanent neurologic deficit were 2% for each. The follow-up was 99% complete, resulting in 427 patient/years. During the follow-up period (mean duration, 4.3 ± 3.2; range, 0.02-11.1 years), only 1 patient developed a relevant aortic insufficiency and required aortic valve reoperation. There were 24 late deaths, which occurred on average 50.0 ± 40.6 months (range, 2.4-135.0) after surgery at the average patient age of 82 ± 5 years (range, 75-90). Estimated survival at 5 and 8 years was 76.4% ± 5.1% and 71.3% ± 5.9%, respectively, and was similar to those of the sex- and age-matched general population.
Reconstructive aortic valve surgery is a suitable and justifiable surgical option in selected elderly patients undergoing operation by surgeons with considerable experience in this kind of surgery. It offers low cardiac and valve-related mortality and morbidity, leading to life expectancy applicable to the patients' ages. |
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| AbstractList | The aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more.
Between November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or more (mean, 78 ± 3; range, 75-88 years), including 17 patients operated on an emergency basis because of acute aortic dissection. None/trivial, mild, moderate, and severe insufficiency grades were presented in 9, 23, 27, and 41 patients, respectively. The surgery comprised root repair, cusp repair, and a combination of both in 45, 16, and 39 patients, respectively.
Early (30-day) mortality and the rate of permanent neurologic deficit were 2% for each. The follow-up was 99% complete, resulting in 427 patient/years. During the follow-up period (mean duration, 4.3 ± 3.2; range, 0.02-11.1 years), only 1 patient developed a relevant aortic insufficiency and required aortic valve reoperation. There were 24 late deaths, which occurred on average 50.0 ± 40.6 months (range, 2.4-135.0) after surgery at the average patient age of 82 ± 5 years (range, 75-90). Estimated survival at 5 and 8 years was 76.4% ± 5.1% and 71.3% ± 5.9%, respectively, and was similar to those of the sex- and age-matched general population.
Reconstructive aortic valve surgery is a suitable and justifiable surgical option in selected elderly patients undergoing operation by surgeons with considerable experience in this kind of surgery. It offers low cardiac and valve-related mortality and morbidity, leading to life expectancy applicable to the patients' ages. OBJECTIVESThe aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more. METHODSBetween November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or more (mean, 78 ± 3; range, 75-88 years), including 17 patients operated on an emergency basis because of acute aortic dissection. None/trivial, mild, moderate, and severe insufficiency grades were presented in 9, 23, 27, and 41 patients, respectively. The surgery comprised root repair, cusp repair, and a combination of both in 45, 16, and 39 patients, respectively. RESULTSEarly (30-day) mortality and the rate of permanent neurologic deficit were 2% for each. The follow-up was 99% complete, resulting in 427 patient/years. During the follow-up period (mean duration, 4.3 ± 3.2; range, 0.02-11.1 years), only 1 patient developed a relevant aortic insufficiency and required aortic valve reoperation. There were 24 late deaths, which occurred on average 50.0 ± 40.6 months (range, 2.4-135.0) after surgery at the average patient age of 82 ± 5 years (range, 75-90). Estimated survival at 5 and 8 years was 76.4% ± 5.1% and 71.3% ± 5.9%, respectively, and was similar to those of the sex- and age-matched general population. CONCLUSIONSReconstructive aortic valve surgery is a suitable and justifiable surgical option in selected elderly patients undergoing operation by surgeons with considerable experience in this kind of surgery. It offers low cardiac and valve-related mortality and morbidity, leading to life expectancy applicable to the patients' ages. |
| Author | Zacher, Michael Doldurov, Kiril Diegeler, Anno Urbanski, Paul P. Zhan, Xiaochun Jankulovski, Atanas Sodah, Ayman |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29342427$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1007_s00392_018_1280_9 crossref_primary_10_1016_j_hlc_2019_02_007 crossref_primary_10_1007_s11748_018_0920_3 crossref_primary_10_1016_j_jtcvs_2021_09_034 crossref_primary_10_1055_s_0042_1759527 crossref_primary_10_1016_j_jtcvs_2017_12_004 crossref_primary_10_1016_j_jtcvs_2019_07_061 |
| Cites_doi | 10.1016/j.ejcts.2008.08.033 10.1016/S0735-1097(00)01202-X 10.1016/j.athoracsur.2004.12.036 10.1016/j.athoracsur.2015.10.002 10.1136/heart.89.11.1316 10.5830/CVJA-2014-051 10.1510/icvts.2008.187633 10.1093/icvts/ivv030 10.1016/j.jtcvs.2010.07.041 10.1093/ejcts/ezu454 10.1111/jocs.12719 10.1510/icvts.2009.204958 10.12945/j.aorta.2014.14-005 10.1016/j.jtcvs.2016.10.081 10.1093/ejechocard/jeq030 10.1016/j.jtcvs.2009.03.058 10.1016/j.athoracsur.2012.12.027 10.1016/j.ejcts.2009.11.003 10.1016/j.jtcvs.2006.03.053 10.1016/j.athoracsur.2007.12.082 10.12945/j.aorta.2014.14-003 10.1016/j.jtcvs.2017.05.108 |
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| Keywords | aortic root aortic valve TEE VSRR valve repair surgery |
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| Title | Reconstructive aortic valve surgery in the elderly: Techniques and outcomes |
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