ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
William A. Baumgartner
Timothy J. Gardner
Levi Watkins
Vincent L. Gott
Bruce A. Reitz
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Borkon, A. M.
Right arrow Articles by Reitz, B. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Borkon, A. M.
Right arrow Articles by Reitz, B. A.

Ann Thorac Surg 1988;46:270-277
© 1988 The Society of Thoracic Surgeons


Articles

Aortic Valve Selection in the Elderly Patient

A. Michael Borkon, M.D.*, Lisa M. Soule, M.A., Kenneth L. Baughman, M.D., William A. Baumgartner, M.D., Timothy J. Gardner, M.D., Levi Watkins, M.D., Vincent L. Gott, M.D., Kimberlee A. Hall, B.S., Bruce A. Reitz, M.D.

From the Division of Cardiac Surgery and Cardiology, The Johns Hopkins Hospital, Baltimore, MD

* Address reprint requests to Dr. Borkon, Medical Plaza, Suite 50-II, 4320 Wornall Rd, Kansas City, MO 64111.

To determine the influence of valve selection on valve-related morbidity and mortality and patient survival, comparative long-term performance characteristics of mechanical (N = 68) and bioprosthetic (N = 73) heart valves were analyzed for 141 patients more than 70 years old who underwent isolated aortic valve replacement between 1970 and 1985. Cumulative patient follow-up was 491 patient-years (average, 4.3 years per patient). Hospital mortality was 18% and 19% for patients with mechanical valves and bioprosthetic valves, respectively. Survival at 5 years was 61 ± 7% (± the standard error) and 67 ± 10% for recipients of mechanical valves and bioprosthetic valves, respectively. Male sex (p = 0.014) and urgency of operation (p = 0.006) were independent risk factors for hospital mortality. Atrial fibrillation increased valve-related mortality (p = 0.01). No patient required reoperation or experienced structural valve failure. While anticoagulant-related hemorrhage was increased in recipients of mechanical valves (9.2 ± 2.1%/patient-year) compared with recipients of bioprosthetic valves (2.3 ± 1.1%/patient-year), it did not result in a death or lead to permanent disability. There was no difference in freedom from any valve-related complication at 5 years. However, when all morbid events are considered, recipients of bioprosthetic valves experienced fewer valve-related complications than patients receiving mechanical valves (10.7 ± 2.3%/patient-year versus 17.6 ± 2.5%/patient-year, respectively; p < 0.05). The reduced incidence of anticoagulant-related hemorrhage and the infrequent need for warfarin sodium anticoagulation favor selection of a bioprosthetic heart valve in patients older than 70 years.




This article has been cited by other articles:


Home page
Card Surg AdultHome page
J. P. Greelish, R. M. Ahmad, J. M. Balaguer, M. R. Petracek, and J. G. Byrne
Reoperative Valve Surgery
, January 1, 2008; 3(2008): 1159 - 1174.
[Full Text]


Home page
Ann. Thorac. Surg.Home page
B. Chiappini, N. Camurri, A. Loforte, L. Di Marco, R. Di Bartolomeo, and G. Marinelli
Outcome after aortic valve replacement in octogenarians
Ann. Thorac. Surg., July 1, 2004; 78(1): 85 - 89.
[Abstract] [Full Text] [PDF]


Home page
Eur J Cardiothorac SurgHome page
M. Ruel, A. Kulik, F. D. Rubens, P. Bedard, R. G. Masters, A. L. Pipe, and T. G. Mesana
Late incidence and determinants of reoperation in patients with prosthetic heart valves
Eur J Cardiothorac Surg, March 1, 2004; 25(3): 364 - 370.
[Abstract] [Full Text] [PDF]


Home page
Card Surg AdultHome page
J. G. Byrne, B. J. Phillips, and L. H. Cohn
Reoperative Valve Surgery
, January 1, 2003; 2(2003): 1047 - 1056.
[Full Text]


Home page
Eur Heart JHome page
P Kolh, A Kerzmann, L Lahaye, P Gerard, and R Limet
Cardiac surgery in octogenarians. Peri-operative outcome and long-term results
Eur. Heart J., July 2, 2001; 22(14): 1235 - 1243.
[Abstract] [PDF]


Home page
Eur J Cardiothorac SurgHome page
P. R. Vogt, H.-P. Brunner-LaRocca, P. Sidler, G. Zund, K. Truniger, M. Lachat, J. Turina, and M. I. Turina
Reoperative surgery for degenerated aortic bioprostheses: predictors for emergency surgery and reoperative mortality
Eur J Cardiothorac Surg, February 1, 2000; 17(2): 134 - 139.
[Abstract] [Full Text] [PDF]


Home page
ANGIOLOGYHome page
D. J. Miller, L. E. Samuels, M. S. Kaufman, R. J. Morris, M. P. Thomas, and S. K. Brockman
Coronary Artery Bypass Surgery in Nonagenarians
Angiology, August 1, 1999; 50(8): 613 - 617.
[Abstract] [PDF]


Home page
Eur J Cardiothorac SurgHome page
P. Kolh, L. Lahaye, P. Gerard, and R. Limet
Aortic valve replacement in the octogenarians: perioperative outcome and clinical follow-up
Eur J Cardiothorac Surg, July 1, 1999; 16(1): 68 - 73.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
E. Weinschelbaum, P. Stutzbach, M. Oliva, J. Zaidman, A. Torino, and E. Gabe
MANUAL DEBRIDEMENT OF THE AORTIC VALVE IN ELDERLY PATIENTS WITH DEGENERATIVE AORTIC STENOSIS
J. Thorac. Cardiovasc. Surg., June 1, 1999; 117(6): 1157 - 1165.
[Abstract] [Full Text] [PDF]


Home page
Asian Cardiovascular and Thoracic AnnalsHome page
R. Vijayanagar, G. Chan, R. Musunuru, N. Sastry, I. Siegman, N. Rattehalli, and M. Cortelli
Aortic Valve Replacement without Annular Enlargement in Patients with Small Aortic Roots
Asian Cardiovascular and Thoracic Annals, December 1, 1998; 6(4): 279 - 284.
[Abstract] [Full Text] [PDF]


Home page
Eur J Cardiothorac SurgHome page
J. Ninet, F. Tronc, J. Robin, A. Curtil, I. Aleksic, and G. Champsaur
Mechanical versus biological isolated aortic valvular replacement after the age of 70: equivalent long-term results
Eur J Cardiothorac Surg, January 1, 1998; 13(1): 84 - 89.
[Abstract] [Full Text] [PDF]


Home page
Ann. Thorac. Surg.Home page
T. A. Orszulak, H. V. Schaff, C. J. Mullany, B. J. Anderson, D. M. Ilstrup, F. J. Puga, and G. K. Danielson
Risk of thromboembolism with the aortic Carpentier-Edwards bioprosthesis
Ann. Thorac. Surg., February 1, 1995; 59(2): 462 - 468.
[Abstract] [PDF]


Home page
Ann. Thorac. Surg.Home page
T.-P. Tsai, A. Chaux, J. M. Matloff, R. M. Kass, R. J. Gray, M. A. DeRobertis, and S. S. Khan
Ten-year experience of cardiac surgery in patients aged 80 years and over
Ann. Thorac. Surg., August 1, 1994; 58(2): 445 - 450.
[Abstract] [PDF]


Home page
Ann. Thorac. Surg.Home page
E. A. Davis, T. J. Gardner, A. M. Gillinov, W. A. Baumgartner, D. E. Cameron, V. L. Gott, R. S. Stuart, L. Watkins, and B. A. Reitz
Valvular disease in the elderly: Influence on surgical results
Ann. Thorac. Surg., February 1, 1993; 55(2): 333 - 338.
[Abstract] [PDF]


Home page
Ann. Thorac. Surg.Home page
A. C. Galloway, S. B. Colvin, E. A. Grossi, F. G. Baumann, Y. P. Sabban, R. Esposito, G. H. Ribakove, A. T. Culliford, J. N. Slater, E. Glassman, et al.
Ten-year experience with aortic valve replacement in 482 patients 70 years of age or older: Operative risk and long-term results
Ann. Thorac. Surg., January 1, 1990; 49(1): 84 - 93.
[Abstract] [PDF]


Home page
Ann. Thorac. Surg.Home page
A. C. Fiore, K. S. Naunheim, H. B. Barner, D. G. Pennington, L. R. McBride, G. C. Kaiser, and V. L. Willman
Valve replacement in the octogenarian
Ann. Thorac. Surg., July 1, 1989; 48(1): 104 - 108.
[Abstract] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1988 by The Society of Thoracic Surgeons.