Aortic valve replacement for octogenarians

Are small valves bad?

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

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)699-706
Number of pages8
JournalAnnals of Thoracic Surgery
Volume66
Issue number3
DOIs
StatePublished - Sep 1 1998
Externally publishedYes

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Aortic Valve
Hospital Mortality
Disease-Free Survival
Survival
Body Surface Area
Prostheses and Implants
Uncertainty
Multivariate Analysis
Heart Failure
Age Groups
Mortality
Incidence
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Medalion, B., Lytle, B. W., McCarthy, P. M., Stewart, R. W., Arheart, K., Arnold, J. H., ... Cosgrove, D. M. (1998). Aortic valve replacement for octogenarians: Are small valves bad? Annals of Thoracic Surgery, 66(3), 699-706. https://doi.org/10.1016/S0003-4975(98)00691-2

Aortic valve replacement for octogenarians : Are small valves bad? / Medalion, Benjamin; Lytle, Bruce W.; McCarthy, Patrick M.; Stewart, Robert W.; Arheart, Kristopher; Arnold, John H.; Loop, Floyd D.; Cosgrove, Delos M.

In: Annals of Thoracic Surgery, Vol. 66, No. 3, 01.09.1998, p. 699-706.

Research output: Contribution to journalArticle

Medalion, B, Lytle, BW, McCarthy, PM, Stewart, RW, Arheart, K, Arnold, JH, Loop, FD & Cosgrove, DM 1998, 'Aortic valve replacement for octogenarians: Are small valves bad?', Annals of Thoracic Surgery, vol. 66, no. 3, pp. 699-706. https://doi.org/10.1016/S0003-4975(98)00691-2
Medalion B, Lytle BW, McCarthy PM, Stewart RW, Arheart K, Arnold JH et al. Aortic valve replacement for octogenarians: Are small valves bad? Annals of Thoracic Surgery. 1998 Sep 1;66(3):699-706. https://doi.org/10.1016/S0003-4975(98)00691-2
Medalion, Benjamin ; Lytle, Bruce W. ; McCarthy, Patrick M. ; Stewart, Robert W. ; Arheart, Kristopher ; Arnold, John H. ; Loop, Floyd D. ; Cosgrove, Delos M. / Aortic valve replacement for octogenarians : Are small valves bad?. In: Annals of Thoracic Surgery. 1998 ; Vol. 66, No. 3. pp. 699-706.
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