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


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
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):
Benjamin Medalion
Bruce W. Lytle
Patrick M. McCarthy
Robert W. Stewart
John H. Arnold
Floyd D. Loop
Delos M. Cosgrove, III
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 Medalion, B.
Right arrow Articles by Cosgrove, D. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Medalion, B.
Right arrow Articles by Cosgrove, D. M., III

Ann Thorac Surg 1998;66:699-706
© 1998 The Society of Thoracic Surgeons

Original articles: Cardiovascular

Aortic valve replacement for octogenarians: are small valves bad?

Benjamin Medalion, MDa,b, Bruce W. Lytle, MDa,b, Patrick M. McCarthy, MDa,b, Robert W. Stewart, MDa,b, Kristopher L. Arheart, EdDb, John H. Arnold, MDa,b, Floyd D. Loop, MDa,b, Delos M. Cosgrove, III, MDa,b

a Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
b Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Address reprint requests to Dr Lytle, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, 9500 Euclid Ave, F25, Cleveland, OH 44195

Presented at the Thirty-fourth Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 26–28, 1998.

Background. As the population ages, more octogenarians become candidates for aortic valve replacement. Many octogenarians, particularly women, have a small aortic annulus and there is uncertainty as to the optimal management of this situation in that age group.

Method. To examine this issue, we reviewed 248 octogenarians (mean age, 82.6 ± 2.3 years; 58% men) who underwent primary isolated aortic valve replacement (n = 99), or aortic valve replacement and coronary revascularization (n = 149), between 1980 and 1995. Nineteen-millimeter valves were used in 26% of the patients.

Results. In-hospital mortality was 8.9%, 5% for aortic valve replacement alone and 11.4% for aortic valve replacement and coronary revascularization. It was 12.5% for the 19-mm size valves compared with 7.7% for the bigger size valves (p = 0.24). Follow-up (mean interval, 4.4 years) demonstrated survival for all patients of 85%, 60%, and 30% and survival free from cardiovascular events of 80%, 45%, and 21% at 1, 5, and 10 postoperative years, respectively. Multivariate analysis identified triple-vessel disease and preoperative congestive heart failure as associated with increased risk for both in-hospital and late mortality (p < 0.05). Valve size did not influence late survival or event-free survival regardless of body surface area.

Conclusions. The use of small aortic valve prostheses in octogenarians does not adversely affect the incidence of early or late mortality or cardiac events.




This article has been cited by other articles:


Home page
 Eur J Cardiothorac SurgHome page
M. Di Eusanio, D. Fortuna, D. Cristell, P. Pugliese, F. Nicolini, D. Pacini, D. Gabbieri, M. Lamarra, and on behalf of RERIC (Emilia Romagna Cardiac Surgery
Contemporary outcomes of conventional aortic valve replacement in 638 octogenarians: insights from an Italian Regional Cardiac Surgery Registry (RERIC)
Eur J Cardiothorac Surg, June 1, 2012; 41(6): 1247 - 1253.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Cardiothorac SurgHome page
A. Dell'Amore, T. M. Aquino, M. Pagliaro, M. Lamarra, and C. Zussa
Aortic valve replacement with and without combined coronary bypass grafts in very elderly patients: early and long-term results
Eur J Cardiothorac Surg, March 1, 2012; 41(3): 491 - 498.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Langanay, E. Flecher, O. Fouquet, V. G. Ruggieri, B. D. L. Tour, C. Felix, B. Lelong, J.-P. Verhoye, H. Corbineau, and A. Leguerrier
Aortic Valve Replacement in the Elderly: The Real Life
Ann. Thorac. Surg., January 1, 2012; 93(1): 70 - 78.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Di Eusanio and D. Fortuna
Reply to the editor.
J. Thorac. Cardiovasc. Surg., November 1, 2011; 142(5): 1290 - 1290.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Di Eusanio, D. Fortuna, R. De Palma, A. Dell'Amore, M. Lamarra, G. A. Contini, T. Gherli, D. Gabbieri, I. Ghidoni, D. Cristell, et al.
Aortic valve replacement: Results and predictors of mortality from a contemporary series of 2256 patients
J. Thorac. Cardiovasc. Surg., April 1, 2011; 141(4): 940 - 947.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Mihaljevic, E. R. Nowicki, J. Rajeswaran, E. H. Blackstone, L. Lagazzi, J. Thomas, B. W. Lytle, and D. M. Cosgrove
Survival after valve replacement for aortic stenosis: Implications for decision making.
J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1270 - 1279.e12.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. J. Melby, A. Zierer, S. P. Kaiser, T. J. Guthrie, J. D. Keune, R. B. Schuessler, M. K. Pasque, J. S. Lawton, N. Moazami, M. R. Moon, et al.
Aortic Valve Replacement in Octogenarians: Risk Factors for Early and Late Mortality
Ann. Thorac. Surg., May 1, 2007; 83(5): 1651 - 1657.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K. J. Kobayashi, J. A. Williams, L. Nwakanma, V. L. Gott, W. A. Baumgartner, and J. V. Conte
Aortic Valve Replacement and Concomitant Coronary Artery Bypass: Assessing the Impact of Multiple Grafts
Ann. Thorac. Surg., March 1, 2007; 83(3): 969 - 978.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
C. Amarelli, A. Della Corte, G. Romano, G. Iasevoli, G. Dialetto, L. S. De Santo, M. De Feo, M. Torella, M. Scardone, and M. Cotrufo
Left ventricular mass regression after aortic valve replacement with 17-mm St Jude Medical mechanical prostheses in isolated aortic stenosis
J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 512 - 517.
[Abstract] [Full Text] [PDF]

Home page
 Eur J Cardiothorac SurgHome page
R.-U. Kuehnel, R. Puchner, A. Pohl, M. O. Wendt, M. Hartrumpf, M. Pohl, and J. M. Albes
Characteristic resistance curves of aortic valve substitutes facilitate individualized decision for a particular type
Eur J Cardiothorac Surg, March 1, 2005; 27(3): 450 - 455.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. M. Albes, M. Hartrumpf, V. Rudolph, T. Krempl, E. Huttemann, R. Vollandt, and T. Wahlers
Are mechanical valves with enhanced inner diameter advantageous in the small sized aortic annulus?
Ann. Thorac. Surg., November 1, 2003; 76(5): 1564 - 1570.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
G. Tasca, F. Brunelli, M. Cirillo, A. Amaducci, Z. Mhagna, G. Troise, and E. Quaini
Mass regression in aortic stenosis after valve replacement with small size pericardial bioprosthesis
Ann. Thorac. Surg., October 1, 2003; 76(4): 1107 - 1113.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
E. H. Blackstone, D. M. Cosgrove, W.R. E. Jamieson, N. J. Birkmeyer, J. H. Lemmer Jr, D. C. Miller, E. G. Butchart, G. Rizzoli, M. Yacoub, and A. Chai
Prosthesis size and long-term survival after aortic valve replacement
J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 783 - 793.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
I. Florath, U. P. Rosendahl, A. Mortasawi, S. F. Bauer, F. Dalladaku, I. C. Ennker, and J. C. Ennker
Current determinants of operative mortality in 1400 patients requiring aortic valve replacement
Ann. Thorac. Surg., July 1, 2003; 76(1): 75 - 83.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovascular and Thoracic AnnalsHome page
P. Ghosh, M. Djordjevic, R. Schistek, R. Baier, and F. Unger
Does Gender Affect Outcome of Cardiac Surgery in Octogenarians?
Asian Cardiovascular and Thoracic Annals, March 1, 2003; 11(1): 28 - 32.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. H. Freed, J. W. Tam, M. C. Moon, G. E.J. Harding, E. Ahmad, and E. A. Pascoe
Nineteen-millimeter prosthetic aortic valves allow normalization of left ventricular mass in elderly women
Ann. Thorac. Surg., December 1, 2002; 74(6): 2022 - 2025.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
J. K. Willmann, D. Weishaupt, M. Lachat, R. Kobza, J. E. Roos, B. Seifert, T. F. Luscher, B. Marincek, and P. R. Hilfiker
Electrocardiographically Gated Multi-Detector Row CT for Assessment of Valvular Morphology and Calcification in Aortic Stenosis
Radiology, October 1, 2002; 225(1): 120 - 128.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovascular and Thoracic AnnalsHome page
Y. Kawachi, A. Nakashima, Y. Toshima, S. Kimura, and K. Arinaga
Outcome of Cardiac and Thoracic Aortic Operation in Patients over 80 Years Old
Asian Cardiovascular and Thoracic Annals, March 1, 2002; 10(1): 12 - 15.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart J SupplHome page
J. Babin-Ebell, C. Schuster, O. Elert, R. Bergemann, D. Horstkotte, and GELIA Study Group
Influence of valve size on morbidity and mortality for patients with mechanical valve replacements (GELIA 8)
Eur. Heart J. Suppl., December 1, 2001; 3(suppl_Q): Q73 - Q77.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. Z. Bloomstein, I. Gielchinsky, A. D. Bernstein, V. Parsonnet, C. Saunders, R. Karanam, and B. Graves
Aortic valve replacement in geriatric patients: determinants of in-hospital mortality
Ann. Thorac. Surg., February 1, 2001; 71(2): 597 - 600.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
P. K. Ghosh
Small aortic valve prostheses in octogenarians
Ann. Thorac. Surg., May 1, 1999; 67(5): 1543 - 1544.
[Full Text] [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 © 1998 by The Society of Thoracic Surgeons.