Key result
Bioprosthetic valve replacement yields ~74% 10-year survival in patients aged 70 and older.
Why the study?
Because the average lifespan is increasing, it is unclear whether patients older than 70 remain candidates for valve re-replacement after bioprosthetic valve replacement.
Cohort (n=71)
In patients aged 70 and older, bioprosthetic valve replacement offers acceptable 10-year survival, but structural valve degeneration requiring reoperation should be anticipated, especially for mitral valves.
Supports re-replacement consideration in select patients over 70; leaves open need for contemporary prospective validation.
Good long-term results with the bioprosthetic valves for patients 70 years old and older have been reported. However, because the average lifespan is increasing, we aimed to clarify whether patients older than 70 may still be candidates for valve re-replacement. Seventy-one patients 70 years old and older, who received a total of 81 bioprosthetic valve replacements during 73 procedures between 1988 and 2000, were reviewed. There were 8 hospital and 7 late deaths. Ten-year actual survival after valve replacement was 73.5%, and 82.8% when hospital deaths were excluded. During the follow-up period, 2 patients received mitral valve re-replacement. Ten years of freedom from reoperation were found in 66.7% for all valves and in 50.0% for mitral valves. The average lifespan in Japan is currently 77.64 years for men and 84.62 years for women; therefore, valve degeneration in patients who receive bioprosthesis replacement in their early 70s should be anticipated.
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Ueyama et al. (2002) conducted a cohort in Cardiac valve replacement (n=71). Bioprosthetic valve replacement was evaluated on 10-year actual survival. Bioprosthetic valve replacement in patients aged 70 and older resulted in a 10-year actual survival of 73.5% and a 10-year freedom from reoperation of 66.7%.
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