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 Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Galloway, A. C.
Right arrow Articles by Spencer, F. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Galloway, A. C.
Right arrow Articles by Spencer, F. C.

Ann Thorac Surg 1990;49:84-93
© 1990 The Society of Thoracic Surgeons

Articles

Ten-year experience with aortic valve replacement in 482 patients 70 years of age or older: Operative risk and long-term results

A.C. Galloway, MD*,a,b, S.B. Colvin, MDa,b, E.A. Grossi, MDa,b, F.G. Baumann, PhDa,b, Y.P. Sabban, PhDa,b, R. Esposito, MDa,b, G.H. Ribakove, MDa,b, A.T. Culliford, MDa,b, J.N. Slater, MDa,b, E. Glassman, MDa,b, S. Harty, RNa,b, F.C. Spencer, MDa,b

a Division of Cardiovascular Surgery, Department of Surgery, and Division of Cardiology, Department of Medicine, New York University Medical Center, New York, New York USA
b Department of Statistics, City University of New York, New York, New York USA

* Address reprint requests to Dr Galloway, Department of Cardiovascular Surgery, New York University Medical Center, 530 First Ave, Suite 6D, New York, NY 10016.

A retrospective analysis of an institutional experience with aortic valve replacement (AVR) in patients 70 years of age or older during 1976 to 1987 was performed. The study was prompted in part by the current interest in palliative aortic valvoplasty, an interest based to a certain extent on the impression that AVR in the elderly has a high mortality. The mean age of the patients was 75.0 ± 4.0 years (± the standard deviation) (range, 70 to 89 years). Eighty-three percent of patients received porcine valves and 17%, mechanical valves. Preoperatively 32% were in New York Heart Association class III, and 59% were in class IV. Operative mortality was 5.6% for elective isolated AVR for aortic stenosis (19% of all patients), 8.2% for all isolated AVR (38%), and 12.4% overall. Concomitant operative procedures were done in 62.0%; AVR with coronary artery bypass grafting (42%) had an operative mortality of 14.3%. Multivariate analysis showed significant predictors of operative mortality to be emergency operation (p < 0.01), isolated aortic regurgitation (p = 0.01), and previous cardiac operation (p = 0.02). Follow-up (34 ± 27 months) was 94% complete. Five-year survival from late cardiac-related death was 81.0%. The constant yearly hazard rate for late death for patients 70 year of age or older who underwent AVR was 5.42% per year, which is similar to the 5.77% per year rate calculated for age-matched and sex-matched controls. Five-year freedom from reoperation was 99%; from late thromboembolic complications, 91%; and from late anticoagulant-related complications, 94%. Freedom from all valve-related morbidity and mortality was 61% at 5 years. At follow-up, 80% of patients reported symptomatic improvement, and 76% were in New York Heart Association class I or II. These results show that AVR in the elderly is safe and effective, with late survival rates similar to those of the general population. Thus AVR remains the procedure of choice in patients 70 years of age or older with substantial aortic valve disease.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
L. B. Balsam, E. A. Grossi, D. G. Greenhouse, P. Ursomanno, A. DeAnda, G. H. Ribakove, A. T. Culliford, and A. C. Galloway
Reoperative Valve Surgery in the Elderly: Predictors of Risk and Long-Term Survival
Ann. Thorac. Surg., October 1, 2010; 90(4): 1195 - 1201.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Cardiothorac SurgHome page
Y. S. Tjang, Y. van Hees, R. Korfer, D. E. Grobbee, and G. J. M. G. van der Heijden
Predictors of mortality after aortic valve replacement
Eur J Cardiothorac Surg, September 1, 2007; 32(3): 469 - 474.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
I. Martinovic, I. Farah, M. Everlien, S. Lindemann, I. Knez, T. Wittlinger, H. Greve, and P. Vogt
Eight-year results after aortic valve replacement with the CryoLife-O'Brien Stentless Aortic Porcine Bioprosthesis
J. Thorac. Cardiovasc. Surg., September 1, 2005; 130(3): 777 - 777.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
J. Ennker, U. Rosendahl, I. C. Ennker, S. Bauer, and I. Florath
Risk in Elderly Patients After Stentless Versus Stented Aortic Valve Surgery
Asian Cardiovasc Thorac Ann, March 1, 2003; 11(1): 37 - 41.
[Abstract] [Full Text] [PDF]

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
 HeartHome page
B J Bouma, J H P van der Meulen, R B A van den Brink, A E R Arnold, A Smidts, L H Teunter, K I Lie, and J G P Tijssen
Variability in treatment advice for elderly patients with aortic stenosis: a nationwide survey in the Netherlands
Heart, February 1, 2001; 85(2): 196 - 201.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
E. L. Hannan, M. J. Racz, R. H. Jones, J. P. Gold, T. J. Ryan, J.-P. Hafner, and O. W. Isom
Predictors of mortality for patients undergoing cardiac valve replacements in New York State
Ann. Thorac. Surg., October 1, 2000; 70(4): 1212 - 1218.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. L. Milavetz, S. N. Hayes, S. A. Weston, J. B. Seward, C. J. Mullany, and V. L. Roger
Sex Differences in Left Ventricular Geometry in Aortic Stenosis: Impact on Outcome
Chest, April 1, 2000; 117(4): 1094 - 1099.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
K. L. Yun, C. F. Sintek, A. D. Fletcher, T. A. Pfeffer, G. S. Kochamba, M. R. Hyde, J. O. Torpoco, and S. Khonsari
Aortic Valve Replacement With the Freestyle Stentless Bioprosthesis : Five-Year Experience
Circulation, November 9, 1999; 100(90002): II-17 - II-23.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
A M Zaidi, A P Fitzpatrick, D J M Keenan, N J Odom, and G J Grotte
Good outcomes from cardiac surgery in the over 70s
Heart, August 1, 1999; 82(2): 134 - 137.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
B J Bouma, R B A van den Brink, J H P van der Meulen, H A Verheul, E C Cheriex, H P M Hamer, E Dekker, K I Lie, and J G P Tijssen
To operate or not on elderly patients with aortic stenosis: the decision and its consequences
Heart, August 1, 1999; 82(2): 143 - 148.
[Abstract] [Full Text] [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
 Ann. Thorac. Surg.Home page
W.R. E. Jamieson, F. H. Edwards, M. Schwartz, J. W. Bero, R. E. Clark, and F. L. Grover
Risk stratification for cardiac valve replacement. National Cardiac Surgery Database
Ann. Thorac. Surg., April 1, 1999; 67(4): 943 - 951.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home 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 Cardiovasc Thorac Ann, December 1, 1998; 6(4): 279 - 284.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Westaby, X. Y. Jin, T. Katsumata, A. Arifi, and P. Braidley
Valve replacement with a stentless bioprosthesis: Versatility of theporcine aortic root
J. Thorac. Cardiovasc. Surg., September 1, 1998; 116(3): 477 - 481.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
M. Natsuaki, T. Itoh, S. Tomita, and K. Naito
Reversibility of Cardiac Dysfunction After Valve Replacement in Elderly Patients With Severe Aortic Stenosis
Ann. Thorac. Surg., June 1, 1998; 65(6): 1634 - 1638.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. Westaby, H. A. Huysmans, and T. E. David
Stentless Aortic Bioprostheses: Compelling Data From the Second International Symposium
Ann. Thorac. Surg., January 1, 1998; 65(1): 235 - 235.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
P. H. Stone, E. Braunwald, and G. Knatterud
Treatment Strategies for Patients With Ischemic Chest Pain-Reply
JAMA, August 28, 1996; 276(8): 606 - 606.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G.-W. He, G. L. Grunkemeier, and A. Starr
Aortic Valve Replacement in Elderly Patients: Influence of Concomitant Coronary Grafting on Late Survival
Ann. Thorac. Surg., June 1, 1996; 61(6): 1746 - 1751.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
K. Holper, M. Wottke, T. Lewe, L. Baumer, H. Meisner, S.-U. Paek, and F. Sebening
Bioprosthetic and mechanical valves in the elderly: Benefits and risks
Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S443 - S446.
[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 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 © 1990 by The Society of Thoracic Surgeons.