Surgical management of aortic valve disease in elderly patients with and without coronary artery disease: Influence on quality of life

P. A. Kurlansky, Donald Williams, E. A. Traad, Roger Carrillo, M. Zucker, G. Ebra

Research output: Contribution to journalArticle

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Abstract

Aim. The feasibility of coronary artery bypass grafting (CABG) concomitant with aortic valve replacement (AVR) is well established. However, its impact on long-term patient-perceived quality of life (QoL) in the elderly remains undefined. Methods. Retrospective analysis was conducted on 866 patients 65 years of age and over who underwent AVR between October 1976 and December 1999 with a Carpentier-Edwards porcine bioprosthesis. This cohort was divided between those who underwent isolated AVR (n=438) and those with AVR and concomitant CABG (AVR+CABG; n=428). Mean age was 77.0±6.1 years (range, 65 to 91) in the AVR group and 78.2±5.5 years (range, 65 to 93) in the AVR+CABG group. QoL was assessed with the Short Form-36 health survey for survivors at follow-up, which was 97% complete. Results. Operative mortality (OM) was 6.2% (27/438) for the AVR group and 8.9% (38/428) for the AVR±CABG group (P=0.130). The occurrence of hospital complications (P=0.162) and postoperative length of stay (P=0.980) was similar for the 2 groups. Actuarial survival at 10 years was 37.1±3.4% for AVR and 38.7±4% for AVR+CABG patients (P=0088). On multivariate analyses, CABG was not a predictor of either OM or long-term survival. QoL was similar far the 2 groups on the summary components: physical health (39.4±11.4 versus 40.2±12.1; P=0.461) and mental health (50.2±10.8 versus 51.9±10.1; P=0.103). Conclusion. Despite the presence of severe coronary artery disease, CABG preserved the long-term QoL in elderly patients undergoing AVR.

Original languageEnglish
Pages (from-to)215-226
Number of pages12
JournalJournal of Cardiovascular Surgery
Volume48
Issue number2
StatePublished - Apr 1 2007

Fingerprint

Aortic Diseases
Aortic Valve
Coronary Artery Disease
Quality of Life
Coronary Artery Bypass
Bioprosthesis
Survival
Mortality
Health Surveys
Survivors
Length of Stay
Mental Health
Swine
Multivariate Analysis

Keywords

  • Aortic valve, surgery
  • Coronary artery bypass
  • Quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Surgical management of aortic valve disease in elderly patients with and without coronary artery disease : Influence on quality of life. / Kurlansky, P. A.; Williams, Donald; Traad, E. A.; Carrillo, Roger; Zucker, M.; Ebra, G.

In: Journal of Cardiovascular Surgery, Vol. 48, No. 2, 01.04.2007, p. 215-226.

Research output: Contribution to journalArticle

Kurlansky, PA, Williams, D, Traad, EA, Carrillo, R, Zucker, M & Ebra, G 2007, 'Surgical management of aortic valve disease in elderly patients with and without coronary artery disease: Influence on quality of life', Journal of Cardiovascular Surgery, vol. 48, no. 2, pp. 215-226.
Kurlansky, P. A. ; Williams, Donald ; Traad, E. A. ; Carrillo, Roger ; Zucker, M. ; Ebra, G. / Surgical management of aortic valve disease in elderly patients with and without coronary artery disease : Influence on quality of life. In: Journal of Cardiovascular Surgery. 2007 ; Vol. 48, No. 2. pp. 215-226.
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T2 - Influence on quality of life

AU - Kurlansky, P. A.

AU - Williams, Donald

AU - Traad, E. A.

AU - Carrillo, Roger

AU - Zucker, M.

AU - Ebra, G.

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N2 - Aim. The feasibility of coronary artery bypass grafting (CABG) concomitant with aortic valve replacement (AVR) is well established. However, its impact on long-term patient-perceived quality of life (QoL) in the elderly remains undefined. Methods. Retrospective analysis was conducted on 866 patients 65 years of age and over who underwent AVR between October 1976 and December 1999 with a Carpentier-Edwards porcine bioprosthesis. This cohort was divided between those who underwent isolated AVR (n=438) and those with AVR and concomitant CABG (AVR+CABG; n=428). Mean age was 77.0±6.1 years (range, 65 to 91) in the AVR group and 78.2±5.5 years (range, 65 to 93) in the AVR+CABG group. QoL was assessed with the Short Form-36 health survey for survivors at follow-up, which was 97% complete. Results. Operative mortality (OM) was 6.2% (27/438) for the AVR group and 8.9% (38/428) for the AVR±CABG group (P=0.130). The occurrence of hospital complications (P=0.162) and postoperative length of stay (P=0.980) was similar for the 2 groups. Actuarial survival at 10 years was 37.1±3.4% for AVR and 38.7±4% for AVR+CABG patients (P=0088). On multivariate analyses, CABG was not a predictor of either OM or long-term survival. QoL was similar far the 2 groups on the summary components: physical health (39.4±11.4 versus 40.2±12.1; P=0.461) and mental health (50.2±10.8 versus 51.9±10.1; P=0.103). Conclusion. Despite the presence of severe coronary artery disease, CABG preserved the long-term QoL in elderly patients undergoing AVR.

AB - Aim. The feasibility of coronary artery bypass grafting (CABG) concomitant with aortic valve replacement (AVR) is well established. However, its impact on long-term patient-perceived quality of life (QoL) in the elderly remains undefined. Methods. Retrospective analysis was conducted on 866 patients 65 years of age and over who underwent AVR between October 1976 and December 1999 with a Carpentier-Edwards porcine bioprosthesis. This cohort was divided between those who underwent isolated AVR (n=438) and those with AVR and concomitant CABG (AVR+CABG; n=428). Mean age was 77.0±6.1 years (range, 65 to 91) in the AVR group and 78.2±5.5 years (range, 65 to 93) in the AVR+CABG group. QoL was assessed with the Short Form-36 health survey for survivors at follow-up, which was 97% complete. Results. Operative mortality (OM) was 6.2% (27/438) for the AVR group and 8.9% (38/428) for the AVR±CABG group (P=0.130). The occurrence of hospital complications (P=0.162) and postoperative length of stay (P=0.980) was similar for the 2 groups. Actuarial survival at 10 years was 37.1±3.4% for AVR and 38.7±4% for AVR+CABG patients (P=0088). On multivariate analyses, CABG was not a predictor of either OM or long-term survival. QoL was similar far the 2 groups on the summary components: physical health (39.4±11.4 versus 40.2±12.1; P=0.461) and mental health (50.2±10.8 versus 51.9±10.1; P=0.103). Conclusion. Despite the presence of severe coronary artery disease, CABG preserved the long-term QoL in elderly patients undergoing AVR.

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KW - Coronary artery bypass

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