Abstract
Background: Aortic valve surgery is the most essential part of worldwide heart valve surgery. In recent decades, the patient profile has changed even in our country, with the age of patients undergoing aortic valve surgery increasing significantly.
The primary objectives of this study are the early results of aortic valve replacement surgery in patients over 75 years old and the negative predictors that affect hospital mortality.
Materials and Methods: This is a retrospective study of 73 patients over 75 who underwent aortic valve surgery in 2014-2021 in our Cardiac Surgery Service, University Hospital Center “Mother Theresa” in Tirana. The patients' data regarding demographic, preoperative, operative, and postoperative variables were collected from the hospital's medical records. The data are presented in mean values and standard deviation. T-test and chi-squared test are also used.
Results: This study involved 73 patients, 50 males and 23 females. The age range was 75-85, averaging 77.12±2.31 years. Hospital mortality was 4.1%. The incidence of major perioperative complications such as low cardiac output, stroke, respiratory problems, bleeding, atrial fibrillation, wound infection, and conduction disturbances was 6.8%, 2.7 %, 4.1%, 2.7 %, 21.9 %, 2.6%, and 4.2 %.
Conclusions: Aortic valve surgery for elderly patients over 75 can be performed well. Concomitant procedures, prolonged extracorporeal circulation, and emergency intervention expose the patient to a high operative risk.
References
Kolh, P., Kerzmann, A., Honore, C., Comte, L., & Limet, R. (2007). Aortic valve surgery in octogenarians: predictive factors for operative and long-term results. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 31(4), 600–606. https://doi.org/10.1016/j.ejcts.2007.01.003
Ekim H, Kutay V, Tuncer M, Mustafaoglu F, Yakut C. Aort Darligi Olan Hastalarda Aort Kapak Reeplasmaninin. Klinik Sonulari. Van Tip Dergisi. 2005; 12: 228-231
Arslan U, CalIk ES.Postoperative Results of Aortic Valve Replacement in Elderly Patients with Isolated Aortic Stenosis: A Comparative Retrospective Study. JSM Cardiothorac Surg 4(1):1016
Cerillo, A. G., Assal Al Kodami, A., Solinas, M., Andrea Farneti, P., Bevilacqua, S., Maffei, S., Mazzone, A., & Glauber, M. (2007). Aortic valve surgery in the elderly patient: a retrospective review. Interactive cardiovascular and thoracic surgery, 6(3), 308–313. https://doi.org/10.1510/icvts.2006.147728
Chiappini, B., Camurri, N., Loforte, A., Di Marco, L., Di Bartolomeo, R., & Marinelli, G. (2004). Outcome after aortic valve replacement in octogenarians. The Annals of thoracic surgery, 78(1), 85–89. https://doi.org/10.1016/j.athoracsur.2003.12.060
Sohn, B., Choi, J. W., Hwang, H. Y., Kim, K. H., & Kim, K. B. (2018). Aortic Valve Replacement for Aortic Stenosis in Elderly Patients (75 Years or Older). The Korean journal of thoracic and cardiovascular surgery, 51(5), 322–327. https://doi.org/10.5090/kjtcs.2018.51.5.322
Fruitman, D. S., MacDougall, C. E., & Ross, D. B. (1999). Cardiac surgery in octogenarians: can elderly patients benefit? Quality of life after cardiac surgery. The Annals of thoracic surgery, 68(6), 2129–2135. https://doi.org/10.1016/s0003-4975(99)00818-8
Teply, J. F., Grunkemeier, G. L., & Starr, A. (1981). Cardiac valve replacement in patients over 75 years of age. The Thoracic and cardiovascular surgeon, 29(1), 47–50. https://doi.org/10.1055/s-2007-1023440
Collart, F., Feier, H., Kerbaul, F., Mouly-Bandini, A., Riberi, A., Mesana, T. G., & Metras, D. (2005). Valvular surgery in octogenarians: operative risks factors, evaluation of Euroscore and long term results. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 27(2), 276–280. https://doi.org/10.1016/j.ejcts.2004.10.041
Banach, M., Goch, A., Misztal, M., Rysz, J., Jaszewski, R., & Goch, J. H. (2007). Predictors of paroxysmal atrial fibrillation in patients undergoing aortic valve replacement. The Journal of thoracic and cardiovascular surgery, 134(6), 1569–1576. https://doi.org/10.1016/j.jtcvs.2007.08.032
Filardo, G., Hamilton, C., Hamman, B., Hebeler, R. F., Jr, Adams, J., & Grayburn, P. (2010). New-onset postoperative atrial fibrillation and long-term survival after aortic valve replacement surgery. The Annals of thoracic surgery, 90(2), 474–479. https://doi.org/10.1016/j.athoracsur.2010.02.081
Pivatto Júnior, F., Teixeira Filho, G. F., Sant'anna, J. R., Py, P. M., Prates, P. R., Nesralla, I. A., & Kalil, R. A. (2014). Advanced age and incidence of atrial fibrillation in the postoperative period of aortic valve replacement. Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 29(1), 45–50. https://doi.org/10.5935/1678-9741.20140010
Ye, J., Soon, J. L., & Webb, J. (2012). Aortic valve replacement vs. transcatheter aortic valve implantation: Patient selection. Annals of cardiothoracic surgery, 1(2), 194–199. https://doi.org/10.3978/j.issn.2225-319X.2012.06.10
Makkar, R. R., Thourani, V. H., Mack, M. J., Kodali, S. K., Kapadia, S., Webb, J. G., Yoon, S. H., Trento, A., Svensson, L. G., Herrmann, H. C., Szeto, W. Y., Miller, D. C., Satler, L., Cohen, D. J., Dewey, T. M., Babaliaros, V., Williams, M. R., Kereiakes, D. J., Zajarias, A., Greason, K. L., … PARTNER 2 Investigators (2020). Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement. The New England journal of medicine, 382(9), 799–809. https://doi.org/10.1056/NEJMoa1910555
Grube, E, Sinning, J. The “Big Five” Complications After Transcatheter Aortic Valve Replacement: Do We Still Have to Be Afraid of Them?∗. J Am Coll Cardiol Intv. 2019 Feb, 12 (4) 370–372.https://doi.org/10.1016/j.jcin.2018.12.019
Zou, Q., Wei, Z., & Sun, S. (2024). Complications in transcatheter aortic valve replacement: A comprehensive analysis and management strategies. Current problems in cardiology, 49(5), 102478. https://doi.org/10.1016/j.cpcardiol.2024.102478

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