| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2006;82:1385-1390
© 2006 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Heart and Diabetes Center NRW, North-Rhine Westfalia, Ruhr University Bochum, Bad Oeynhausen, Germany
b Department of Cardiology, Heart and Diabetes Center NRW, North-Rhine Westfalia, Ruhr University Bochum, Bad Oeynhausen, Germany
Accepted for publication April 27, 2006.
* Address correspondence to Dr. med. Eitz, Klinik für Thorax- und Kardiovaskularchirurgie, Herz- und Diabeteszentrum NRW, Georgstr. 11, 32545 Bad Oeynhausen, Germany (Email: teitz{at}hdz-nrw.de).
BACKGROUND: Because of increasing life expectancy of patients with heart valve replacement and a limited durability of heart valve bioprostheses, cardiac reoperation becomes necessary in a significant percentage of patients. Reliable data on mortality and risk factors in octogenarians after replacement of aortic valve prostheses are scanty, however.
METHODS: We retrospectively analyzed 71 patients aged 80 years and older who underwent cardiac reoperation of the aortic valve (69 bioprostheses, 2 mechanical prostheses) between 1991 and 2004 at our heart center. Survival rate of the study cohort was compared with a control group of octogenarians matched for age, sex, and year of aortic valve replacement. To assess predictors of 30-day survival and 3-year survival, we performed univariate and multivariate analyses.
RESULTS: Survival rates at 30 days, 1 year, 3 years and 5 years were 83.6%, 76.1%, 70.8%, and 51.3%, respectively. Results did not differ significantly between the study cohort and the controls. Patients with reoperation had an estimated median survival of 5.6 years. Postoperative complications such as low cardiac output syndrome and intestinal failure were the only independent predictors of 30-day survival (p = 0.020 and p = 0.015, respectively). Low cardiac output, intestinal failure, and diabetes mellitus were independent predictors of 3-year survival (p = 0.001 to 0.033).
CONCLUSIONS: Our data demonstrate that it is possible to achieve an acceptable outcome in octogenarians who have reoperation of the aortic valve prosthesis. Early and mid-term survival is predominantly influenced by unexpected postoperative complications and not by preoperative risk factors, with the exception of diabetes mellitus.
Related Article
Ann. Thorac. Surg. 2006 82: 1391.
This article has been cited by other articles:
|
|
 |
|
  M. Krane, R. Bauernschmitt, A. Hiebinger, M. Wottke, B. Voss, C. C. Badiu, and R. Lange Cardiac reoperation in patients aged 80 years and older. Ann. Thorac. Surg., May 1, 2009; 87(5): 1379 - 1385. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Khaladj, M. Shrestha, S. Peterss, I. Kutschka, M. Strueber, L. Hoy, A. Haverich, and C. Hagl Isolated surgical aortic valve replacement after previous coronary artery bypass grafting with patent grafts: is this old-fashioned technique obsolete? Eur. J. Cardiothorac. Surg., February 1, 2009; 35(2): 260 - 264. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Maleszka, G. Kleikamp, A. Zittermann, M. R.G. Serrano, and R. Koerfer Simultaneous Aortic and Mitral Valve Replacement in Octogenarians: A Viable Option? Ann. Thorac. Surg., December 1, 2008; 86(6): 1804 - 1808. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Brown, H. V. Schaff, B. D. Lahr, C. J. Mullany, T. M. Sundt, J. A. Dearani, C. G. McGregor, and T. A. Orszulak Aortic valve replacement in patients aged 50 to 70 years: Improved outcome with mechanical versus biologic prostheses. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 878 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Vicchio, A. Della Corte, L. S. De Santo, M. De Feo, G. Caianiello, M. Scardone, and M. Cotrufo Tissue Versus Mechanical Prostheses: Quality of Life in Octogenarians Ann. Thorac. Surg., April 1, 2008; 85(4): 1290 - 1295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Eitz, S. Schenk, D. Fritzsche, A. Bairaktaris, O. Wagner, H. Koertke, and R. Koerfer International Normalized Ratio Self-Management Lowers the Risk of Thromboembolic Events After Prosthetic Heart Valve Replacement Ann. Thorac. Surg., March 1, 2008; 85(3): 949 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Walther, J. Kempfert, M. A. Borger, J. Fassl, V. Falk, J. Blumenstein, M. Dehdashtian, G. Schuler, and F. W. Mohr Human Minimally Invasive Off-Pump Valve-in-a-Valve Implantation Ann. Thorac. Surg., March 1, 2008; 85(3): 1072 - 1073. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Walther, V. Falk, T. Dewey, J. Kempfert, F. Emrich, B. Pfannmuller, P. Broske, M. A. Borger, G. Schuler, M. Mack, et al. Valve-in-a-Valve Concept for Transcatheter Minimally Invasive Repeat Xenograft Implantation J. Am. Coll. Cardiol., July 3, 2007; 50(1): 56 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Koertke, A. Zittermann, O. Wagner, and R. Koerfer Self-Management of Oral Anticoagulation Therapy Improves Long-Term Survival in Patients With Mechanical Heart Valve Replacement Ann. Thorac. Surg., January 1, 2007; 83(1): 24 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W. Akins Invited commentary. Ann. Thorac. Surg., October 1, 2006; 82(4): 1391 - 1391. [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 |
