Mechanical versus biological aortic valve implants in the elderly. A comparison of early and mid-term results

• Published in: Arquivos brasileiros de cardiologia 2001-11, Vol.77 (5), p.395-398
• Main Authors: Thulin, L I, Sjögren, J L
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; aortic valve; Aortic Valve - surgery; Bioprosthesis; CARDIAC & CARDIOVASCULAR SYSTEMS; cardiac surgery; elderly; Female; Follow-Up Studies; heart valve prosthesis; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Humans; Male; Retrospective Studies; Survival Rate; Treatment Outcome
• ISSN: 0066-782X; 1678-4170; 0066-782X; 1678-4170
• DOI: 10.1590/S0066-782X2001001100001

Our aim was to compare, in a non randomized study, the surgical outcome in elderly patients with mechanical (Group 1; n=83) and bioprosthetic valve implants (Group 2; n=136). During a three year period, 219 patients >75 years underwent Aortic Valve Replacement. The groups matched according to age, sex, comorbidity, valve pathology and concomitant Coronary Artery Bypass Surgery. Follow-up was a total of 469 patient-years (mean follow-up 2.1 years, maximum 4,4 years). Operative mortality was zero and the overall early mortality was 2.3 % (within 30 days). Actuarial survival was 87.5 +/- 4.0% and 66.1 +/- 7.7% (NS) at 4 years in Group 1 and Group 2, respectively. Freedom from valve-related death was 88.9 +/- 3.8% in Group 1 and 69.9+/-7.9% (NS) in Group 2 at 4 years. Aortic Valve Replacement in the elderly (>75 years) is a safe procedure even in cases where concomitant coronary artery revascularization is performed. Only a few anticoagulant-related complications were reported and this may indicate that selected groups of elderly patients with significant life expectancy may benefit from mechanical implants.