Aortic valve replacement in the elderly. Encouraging postoperative clinical and hemodynamic results
M. S. Hochberg, A. G. Morrow, L. L. Michaelis, C. L. McIntosh, D. R. Redwood and S. E. Epstein
Seventy-three patients aged 60 and over and 277 patients under 60 years of
age underwent isolated aortic valve replacement (AVR) for aortic stenosis,
regurgitation, and mixed disease from 1966 through 1975. Cardiac
catheterization was performed five to nine months following operation in
77% of these patients. Follow-up averaged 55 months per patient. The
hospital mortality in the elderly group was 2.7%, compared to 5.8% in the
younger group. The late cardiac mortality was 21% and 19%, respectively.
There was significant improvement (P less than .001) in the left
ventricular end-diastolic pressure, cardiac index, and functional class in
each of the three disease groups in the younger as well as the elderly
patients. More important, the magnitude of improvement in each of these
variables in patients over and under 60 years of age was not significantly
different. Increasing longevity will make cardiac operations more common in
the older population. These findings indicate that AVR carries the same low
risk and brings about a similar improvement in left ventricular pump
function in patients older and younger than 60.
