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Aortic valve surgery in the elderly patient: a retrospective review

Operative Unit of Adult Cardiac Surgery, Ospedale ‘G. Pasquinucci’, Institute of Clinical Physiology, The National Research Council, Via Aurelia Sud 54100 Massa, Italy

*Corresponding author. Tel.: +39-0585493604; fax: +39-0585493614.

E-mail address: Cerillo{at}ifc.cnr.it (A.G. Cerillo).

Elderly patients are referred with increasing frequency for aortic valve replacement (AVR), due to the ageing of the population and to improved results of surgery. We retrospectively analysed the in-hospital and short-term (up to three years) results of AVR in 185 patients aged 75 years, operated on at our institution from January 2000 to December 2003. Follow-up was completed by a telephone interview during January 2005. Hospital mortality was 6.5% (12 patients). A non-elective operation (P=0.001), preoperative NYHA functional class III (P=0.06), and chronic renal failure (P=0.02) were associated with increased operative mortality. Of note, age 80 years did not increase the surgical risk. The 4-year actuarial survival was 70.5%, the event-free survival was 60.6%, and almost all of the interviewed patients thought that they had benefited from the operation. Preoperative intubation, a NYHA class III, and a non-elective operation were univariate predictors of a poorer outcome. Our data show that aortic valve replacement may be performed with low morbidity and mortality in the elderly patient (age 75 years), and that an age 80 years neither increases the surgical risk, nor significantly worsens the short-term outcome.

Key Words: Aortic valve replacement; Octogenarian patients; Cardiac surgery; Symptomatic status