Conference paper
Authors list: Florath, Ines; Albert, Alexander; Boening, Andreas; Ennker, Ina Carolin; Ennker, Juergen
Publication year: 2010
Pages: 1304-1310
Journal: European Journal of Cardio-Thoracic Surgery
Volume number: 37
Issue number: 6
ISSN: 1010-7940
eISSN: 1873-734X
Open access status: Bronze
DOI Link: https://doi.org/10.1016/j.ejcts.2009.12.025
Conference: 23rd Annual Techno-College Meeting of the European-Association-for-Cardio-Thoracic-Surgery (EACTS)
Publisher: Oxford University Press
Abstract:
Objective: This study identifies high-risk octogenarians for surgical aortic valve replacement (AVR) because with the current advances in transcatheter valve therapy, a definition of patient selection criteria is essential. Methods: Between 1996 and 2006, 493 consecutive octogenarians with symptomatic aortic stenosis underwent AVR with and without (51%) concomitant coronary artery bypass grafting (CABG). To identify high-risk patient groups, risk factors of 6-month mortality were determined using multivariable logistic regression. Results: The 30-day mortality rate was 8.4% and it increased up to 15.2% until 6 months after AVR. Independent risk factors of 6-month mortality were patients older than 84 years (odds ratio (OR): 2.2 (1.29-3.61)), left ventricular ejection fraction <60% (OR: 2.5 (1.35-4.61)), body mass index (BMI) <24 (OR: 2.0 (1.22-3.36)), creatinine (OR: 1.6 (1.04-2.53)) and blood glucose (OR: 1.01 (1.001-1.009)). High-risk groups were patients older than 84 years with an ejection fraction <60% (6-month mortality 28%) and patients younger than 84 years with an ejection fraction <60% and a BMI <24 (6-month mortality 23.2%). These high-risk groups comprised 37% of the patient population. After isolated AVR, the 30-day mortality and survival at 1 and 5 years was 11.6%, 69% and 35% in this high-risk group, respectively. In octogenarians with an STS score >10 and an EuroScore >20, the 30-day mortality and survival at 1 year was 10.5% and 80%, 11.6% and 77%, respectively. Conclusions: In most octogenarians, AVR is a safe and beneficial procedure. In high-risk octogenarians, identified by STS score >10, EuroScore >20 and by simple three risk factors (age >84 years, ejection fraction <60% and BMI <24), the mortality after surgical AVR was no different from the currently reported outcome after transcatheter AVI. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Citation Styles
Harvard Citation style: Florath, I., Albert, A., Boening, A., Ennker, I. and Ennker, J. (2010) Aortic valve replacement in octogenarians: identification of high-risk patients, European Journal of Cardio-Thoracic Surgery, 37(6), pp. 1304-1310. https://doi.org/10.1016/j.ejcts.2009.12.025
APA Citation style: Florath, I., Albert, A., Boening, A., Ennker, I., & Ennker, J. (2010). Aortic valve replacement in octogenarians: identification of high-risk patients. European Journal of Cardio-Thoracic Surgery. 37(6), 1304-1310. https://doi.org/10.1016/j.ejcts.2009.12.025
Keywords
30-DAY; IMPLANTATION; SOCIETY; STENOSIS; STRATIFICATION; Valves
