Early and long-term outcomes in Japanese patients aged 80 years or older undergoing conventional aortic valve replacement

Abstract

In this study, we investigated the early and long-term results of conventional aortic valve replacement (AVR) in very old patients. Methods: Seventy-fve patients with aortic stenosis underwent conventional AV R for patients aged 80 years.We examined early death and major adverse cardiovascular and cerebrovas-cular event (MACCE). Results: The operative mortality was 0% for isolated AVR and 19.2% for concomitant surgery. The postoperative survival rate and MACCE free-rate were no significant differences between the isolated AV R and the concomitant surgery. Univariate analysis confrmed that cardiac dysfunction, severe chronic kidney disease (CKD), hemodialysis, + coronary artery bypass grafting, and norepinephrine use were risk factor of early death. Univariate analysis confrmed that severe CKD, BNP >1000 pg/ml, aortic cross clamping time (ACCT) >180 min, and non-use carperitide and multivariate analysis confrmed that ACCT >180 min, and non-use carperitide were risk factor of MACCE. Conclusions: This study showed that the results of conventional AV R in very old patients were not satisfactory. However, the results obtained with isolated AV R were favorable with no operative deaths. The present study demonstrated that preoperative cardiac function, preoperative renal function, and operative factors have an important impact on early mortality and MACCE.