Key result
Aortic valve surgery at age ≥70 shows similar 30-day mortality to ages 50-69 but higher AFib risk.
Why the study?
This study was conducted to evaluate the clinical outcomes of aortic valve surgery in elderly patients and to determine factors associated with atrial fibrillation.
Does advanced age (≥70 years) worsen clinical outcomes and increase the risk of atrial fibrillation in patients undergoing isolated aortic valve replacement for aortic stenosis?
Cohort (n=54)
Does advanced age (≥70 years) worsen clinical outcomes and increase the risk of atrial fibrillation in patients undergoing isolated aortic valve replacement for aortic stenosis?
Advanced age (≥70 years) in patients undergoing isolated aortic valve replacement is associated with increased morbidity and new-onset atrial fibrillation, but not with increased short-term or 6-month mortality compared to younger patients.
Answers are grounded in this paper and cite their sources.
Similar short-term mortality but higher AF risk in elderly AVR patients; leaves open need for age-stratified prevention trials.
Background: This study was conducted to evaluate the clinical outcomes of aortic valve surgery in elderly patients and to determine the factors associated with atrial fibrillation.Methods: Between 2011 and 2015, 54 patients who underwent isolated aortic valve replacement for aortic stenosis without preoperative arrhythmia were divided into two groups as 50-69 years old (group I; n=25) and 70 years and older (group II; n=29). Patient's medical record was retrospectively reviewed. Pre, peri and post operation data was compared. The deaths that occurred in the first 30 days were evaluated as mortality and complications as morbidity.Results: Mortality rate was found 9.2% (5/54) (p=0.358) in the first 30 days and 8.1% (4/49) the first six months follow-up and no difference was found between the two groups (p=0.153). The following parameters were observed in group 2 and were found statistically significant: average age (p<0.01), euroscore (p<0.01), duration of cardiopulmonary bypass (p<0.01), duration of mechanical ventilation (p<0.01), duration of stay in intensive care unit (p<0.01), duration of stay hospital (p=0.01), acute renal failure (p=0.03), the need for dialysis (p<0.01), atrial fibrillation (p=0.04), pneumonia (p=0.03) and pleural fluid (p=0.01). We found that new-onset atrial fibrillation associated with advanced age (p=0.02), hypertension (p=0.04), duration of cardiopulmonary bypass (p=0.03), duration of aortic cross-clamp (p<0.01), postoperative anaemia (p=0.04), high creatinine values (p<0.01) and cerebrovascular events (p<0.01).Conclusions: Mortality rate was found 9.2% (5/54) (p=0.358) in the first 30 days and 8.1% (4/49) the first six months follow-up and no difference was found between the two groups (p=0.153). The following parameters were observed in group 2 and were found statistically significant: average age (p<0.01), euroscore (p<0.01), duration of cardiopulmonary bypass (p<0.01), duration of mechanical ventilation (p<0.01), duration of stay in intensive care unit (p<0.01), duration of stay hospital (p=0.01), acute renal failure (p=0.03), the need for dialysis (p<0.01), atrial fibrillation (p=0.04), pneumonia (p=0.03) and pleural fluid (p=0.01). We found that new-onset atrial fibrillation associated with advanced age (p=0.02), hypertension (p=0.04), duration of cardiopulmonary bypass (p=0.03), duration of aortic cross-clamp (p<0.01), postoperative anaemia (p=0.04), high creatinine values (p<0.01) and cerebrovascular events (p<0.01).
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Borulu et al. (2021) conducted a cohort in Aortic stenosis without preoperative arrhythmia (n=54). Aortic valve surgery (age ≥70 years) vs. Aortic valve surgery (age 50-69 years) was evaluated on 30-day mortality (p=0.358). Aortic valve surgery in patients ≥70 years showed similar 30-day mortality to those 50-69 years (p=0.358), but was associated with increased new-onset atrial fibrillation (p=0.02).
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