Aortic valve replacement in patients over 80 years of age

Abstract

Aim: To evaluate the outcomes of aortic valve replacement in patients over 80 years of age. Methods: In the 1997-2007 period, a total of 91 patients aged over 80 years had surgery at the Department of Cardiac Surgery of the Institute for Clinical and Experimental Medicine. Both early (30-day) and late mortality of these patients undergoing aortic valve replacement was assessed. Using statistical methods, an attempt was made to identify risk factors involved in early and late mortality and, also, independent risk factors for late mortality. Results: Early and late mortality was 6.6% and 28.6%, respectively, with a mean follow-up period of 33 months. One-, three-, and five-year cumulative survival was 84%, 76% and 69%, respectively. Using univariate analysis, the risk factors affecting short-term survival included age and off-pump time while the risk factors impacting on late mortality included age, off-pump time, blood loss, and intubation time, with a statistical significance of p < 0.05. Independent risk factors affecting long-term survival, as assessed using multivariate analysis, included age, off-pump time, and intubation time. The mean age of our group was 82 years and the life expectancy was not different from the life expectancy of the healthy population of the same age in the Czech Republic. Conclusion: Aortic valve replacement in patients aged over 80 is a method extending life and improving its quality despite increased morbidity and mortality rates in this age group. When scheduling such a patient for surgery, the surgical risk and the patient's overall health status are to be considered carefully.