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eComment: Re: Long-term follow-up of elderly patients subjected to aortic valve replacement with mechanical prostheses

Bakoulev Scientific Center for Cardiovascular Surgery, 121552 Moscow, Russia

Long-term follow-up of elderly patients subjected to aortic valve replacement with mechanical prostheses

Due to the growth of the geriatric population the number of older patients undergoing open-heart surgery has significantly increased. Over the past decade the use of bioprosthetic valves in the elderly has been well established. However, the respective advantages and disadvantages of the two types of valves: mechanical and bioprostheses are well known – the risk of re-intervention in the elderly versus the risk of anticoagulant-related complications [1–4].

This article presents the study on the follow-up of elderly patients with aortic valve replacement using mechanical prostheses [1]. The authors analysed 144 patients 65–75 years old. The particularity of the study was the long follow-up of the patient population, up to 20 years. The study showed adequate hospital and late mortality, rather high risk of thromboembolic events. Actuarial Kaplan–Meier analysis demonstrated high patient survival in the study. At the completion of this study more than half of the patients were alive, with ages ranging from 77 to 91 years. We consider this to be a positive result for the examined group of patients.

Having performed 459 open-heart surgical procedures in the elderly for the last 15 years we have estimated the efficiency of mechanical valve implantations in this group of patients. In summary, the results reported in this article present a valuable analysis and suggest that mechanical valves can be used safely in older patients.

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1. Coutinho GF, Pancas R, Antunes PE, Antunes MJ. Long-term follow-up of elderly patients subjected to aortic valve replacement with mechanical prostheses. Interact CardioVasc Thorac Surg 2009;9:576–582.[Abstract/Free Full Text]
2. Masters RG, Semelhago LC, Pipe AL, Keon WJ. Are older patients with mechanical heart valves at increased risk? Ann Thorac Surg 1999;68:2169–2172.[Abstract/Free Full Text]
3. Khan S. Long-term outcomes with mechanical and tissue valves. J Heart Valve Dis 2002;11(Suppl_1):S8–S14.[Medline]
4. El Oakley R, Kleine P, Bach DS. Choice of prosthetic heart valve in today’s practice. Circulation 2008;117:253–256.[Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A. Bockeria Permission Requests Google Scholar Articles by Bockeria, L. A. Articles by Olofinskaya, I. E. PubMed PubMed Citation Articles by Bockeria, L. A. Articles by Olofinskaya, I. E. Related Collections Related Article