Elderly patients undergoing minimally invasive aortic valve replacement experienced higher rates of major bleeding (7.7% vs. 4.1%) and new permanent pacemaker implantation (10% vs. 5.8%).
Is minimally invasive aortic valve replacement (MIAVR) safe and feasible in elderly patients (≥70 years) compared to younger patients (<70 years)?
Minimally invasive aortic valve replacement is a feasible and safe surgical option in elderly patients, though it is associated with higher rates of bleeding, pacemaker implantation, and sepsis compared to younger patients.
Absolute Event Rate: 0% vs 0%
Background/Objectives: Transcatheter aortic valve implantation (TAVI) has become the leading treatment option for patients suffering from aortic valve stenosis aged over 70, except in cases of specific contraindications like bicuspid valves, inappropriate access routes, or endocarditis. Minimally invasive aortic valve replacement (MIAVR) has emerged as a potential way to combine the durability of surgery with reduced procedural trauma. This study aims to assess the safety and feasibility of MIAVR in elderly patients. Methods: A total of 990 patients were included in this retrospective cohort study. Among them, 261 (26%) were aged 70 years or older (elderly cohort), and 729 (74%) were younger than 70 years (younger cohort). All patients were followed for at least 30 days postoperatively, with survival data collected through May 2025. Multivariable logistic regression, linear regression, and Kaplan–Meier survival analyses were performed. Results: Elderly patients were more likely to be female (51% vs. 40%, p = 0.001) and carried a heavier burden of vascular and renal comorbidity: renal impairment 33% vs. 17% and extracardiac arteriopathy 45% vs. 30% (both p 0.20). Overall, 30-day mortality was 2.4% (24/990), with crude mortality approximately threefold higher among patients aged ≥70 years (4.6% vs. 1.6%). Conclusions: Our findings indicate that MIAVR is a feasible and safe surgical option across age groups; Elevated morbidity in elderly patients is primarily due to bleeding, pacemaker implantation, and sepsis, while rates of stroke, renal failure, and myocardial infarction are low.
Amanov et al. (Fri,) reported a other. Elderly patients undergoing minimally invasive aortic valve replacement experienced higher rates of major bleeding (7.7% vs. 4.1%) and new permanent pacemaker implantation (10% vs. 5.8%).