What question did this study set out to answer?

To evaluate the operative morbidity, early mortality, and long-term functional survival of octogenarians undergoing valvular heart surgery.

April 1, 1992European Heart JournalOpen Access

Valve replacement in octogenarians: increased early mortality but good long-term result

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Why the study?

Does valvular surgery improve symptoms and provide acceptable survival in octogenarians with severe valvular disease?

Population

20 patients aged 80 years or older undergoing valvular surgery. All patients were in NYHA class III and IV…

Design

Case_series

Follow-up

mean 20 +/- 8 months (range 6 to 70 months)

Authors

TCTP CarrelUniversity Hospital of Basel ALA LaskeSiemens (Germany)EBE BauerUniversity of Agriculture in Krakow

Discussion

Member takes

Implication

May support valve surgery for symptom relief in selected octogenarians; leaves open optimal selection and comparisons to transcatheter options.

Key Points

To evaluate the operative morbidity, early mortality, and long-term functional survival of octogenarians undergoing valvular heart surgery.
Retrospective cohort analysis of N=20 patients aged 80 to 87 years (mean 82 ± 1.5 years) who underwent valvular surgery between January 1983 and December 1990.
Surgical indications included aortic stenosis (n=19) and mitral insufficiency (n=1); four patients underwent concomitant coronary artery bypass grafting, with procedures performed electively (n=15), urgently (n=2), or emergently (n=3).
Postoperative follow-up was conducted for 6 to 70 months (mean 20 ± 8 months) to assess functional capacity and actuarial survival.
Operative mortality was 15% (3/20 patients), with 70% (14/20) experiencing postoperative complications and 30% (6/20) having an uneventful hospital course.
All patients presented preoperatively with severe functional limitation in NYHA class III or IV, whereas all surviving patients improved to NYHA class I or II.
Actuarial survival rates following surgery were 78.5% at 1 year and 67% at 5 years.

Structured PICO

Does valvular surgery improve symptoms and provide acceptable survival in octogenarians with severe valvular disease?

Population

20 patients aged 80 years or older (mean age 82 +/- 1.5 years) undergoing valvular surgery (19 for aortic stenosis, 1 for mitral insufficiency). All patients were in NYHA class III and IV before operation.

Intervention

Valvular surgery (valve replacement, with 4 patients also receiving coronary artery bypass grafting)

Outcome

Operative mortality and long-term survivalhard clinical

Valve replacement in octogenarians is feasible and provides good long-term survival and symptomatic improvement, despite a high rate of perioperative complications.

Cite This Study

Carrel et al. (1992) studied this question.

synapsesocial.com/papers/6a8b8dce0269824ff833736e https://doi.org/10.1093/oxfordjournals.eurheartj.a060205

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Implication

May support valve surgery for symptom relief in selected octogenarians; leaves open optimal selection and comparisons to transcatheter options.

Valve replacement in octogenarians: increased early mortality but good long-term result

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Valve replacement in octogenarians: increased early mortality but good long-term result

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider