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KMID : 0364020180510050322
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Korean Journal of Thoracic and Cardiovascular Surgery
2018 Volume.51 No. 5 p.322 ~ p.327
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Aortic Valve Replacement for Aortic Stenosis in Elderly Patients (75 Years or Older)
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Sohn Bong-Yeon
Choi Jae-Woong
Hwang Ho-Young
Kim Kyung-Hwan
Kim Ki-Bong
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Abstract
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Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation.
Methods: Between 2001 and 2018, 94 patients aged ≥75 years underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6?174 months).
Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival.
Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and post-operative complications, particularly paravalvular leak and permanent pacemaker insertion.
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KEYWORD
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Aortic valve replacement, Aortic valve stenosis, Aged, Transcatheter aortic valve implantation
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