Aortic Valve replacement in Octogenarian Patients. Perioperative results and Mid-term Follow-up

Introduction: Over the last decades the number of elderly patients requiring cardiac surgery dueto degenerative aortic stenosis has consistently increased. The aim of this study is tocommunicate the experience of a center on aortic valve replacement in this octogenarianpopulation and their mid-term follow-up.Methods: From January 2005 to December 2010, 96 patients older than 80 years with degenerativesevere aortic stenosis, underwent aortic valve replacement surgery combinedor not with coronary artery bypass grafting at the Hospital Universitario Fundación Favaloro. Retrospective morbidity and mortality data were compared between bothpopulations. Follow-up to analyse quality of life was made through personal andtelephone interviews.Results: Mean age of the population was 82±2 years and 54% were men. Exercise-induceddyspnea was the most common symptom present in 84% of the study population.Eighty-four patients (77%) presented with some degree of previous renal dysfunction.According to the additive EuroSCORE, 78.1% of patients were at high and17.7% at very high surgical risk. Isolated aortic valve replacement was performedin 55 patients (group I) and combined with coronary artery bypass grafting in theremaining 41 (group II). Overall 30-day mortality was 7.3%, 3.6 % in group I and12.2% in group II (NS). Taking into account elective surgeries, these percentageswere reduced to 5.3%, 4.3% and 6.9%, respectively (NS). During the 6-month followup,cumulative mortality was 14%, 94% of patients are in FC I-II of the NYHA classificationand 88% were not re-admitted for a cardiovascular cause.Conclusions: Aortic valve replacement in octogenarian patients combined or not with coronaryartery bypass grafting is a procedure with good short and mid-term outcome whenperformed electively in an experienced center. Therefore, it should not be contraindicatedconsidering only age or cardiac operative risk scores.