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Risk profile and outcomes of aortic valve replacement in octogenarians

World Journal of Cardiology 2011年第11期3卷 359-366页

作者： sujatha kesavan Aamer Iqbal Yusra Khan Jonathan Hutter Katie Pike Chris Rogers Mark Turner Mandie Townsend Andreas Baumbach Academic Tutor and Research Fellow in Car-diology University of Bristol and Bristol Heart Institute Medical students University of Bristol Clinical Lead and Consultant Cardiothoracic Surgeon University of Bristol and the Bristol Heart Institute Clinical Trials Evaluation Unit Bris-tol Heart Institute Consultant Cardiologist University of Bristol and the Bristol Heart Institute Honorary Reader in Cardiology and Consultant Cardiologist Bristol Heart Institute and University of Bristol

AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.

关键词： Aortic valve replacement Transcatheter aortic valve implantation Logistic EuroSCORE Coronary artery bypass grafting

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