Results of minimally-invasive aortic-valve replacement in octogenarians
- 291 Downloads
KeywordsAortic Valve Valve Replacement Transcatheter Aortic Valve Implantation Permanent Pacemaker Operative Record
Minimally-invasive aortic-valve replacement (mini-AVR) via J-sternotomy has been shown to reduce surgical morbidity. Little data is available on the outcomes of mini-AVR in the very elderly population.
We assessed the clinical outcomes of mini-AVR in all octogenarians undertaken at our centre.
A single consultant surgeon routinely undertook the minimally-invasive approach via J-sternotomy for all isolated first-time aortic valve replacements. Operative records and clinical outcomes of all patients who had undergone miniAVR in our centre between 2006-2015 were retrieved from the national cardiac surgery database. Patient demographics, premorbid status, operative details and outcomes were evaluated.
171 mini-AVRs were undertaken between 2006 and 2015, out of which 41 patients were aged 80 or above. Patient demographics were as follows: mean age 83.8 years (range 80-91, SD 2.934), female gender 63.4%, diabetes mellitus 9.8%, pulmonary disease 22.0%, LV function: <30% in 7.3%, 30-5% in 17.1% and >50% in 75.6%, logistic euroSCORE 13.3 (interquartile range 8.44 - 14.7, SD 9.04). Overall in-hospital and 30-day mortality was 2.4% (1/41), re-exploration rate was 0.0%, renal failure requiring dialysis 2.4% (1/41), permanent pacemaker 2.4% (1/41), CVA 0.0%, conversion to full sternotomy 0.0%.
Despite high logistic EuroSCOREs, we have shown excellent results in octogenarians by this approach. In this era of transcatheter aortic valve implantation, mini-AVR needs to be in the armamentarium of the surgical team.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.