Octogenarians undergoing combined aortic valve replacement and myocardial revascularization: perioperative mortality and medium-term survival.

Aim of the study was to answer the question whether the mortality and morbidity of octogenarians undergoing combined aortic valve replacement and myocardial revascularization (AVR + CABG) is higher than that of younger patients. Between 01/1995 and 12/2002, 242 patients underwent AVR + CABG in our institution. 37 patients were older than 80 years (16 male, 21 female, median pressure gradient over the aortic valve: 53 mmHg, median EF: 62%), 205 patients were younger than 80 years (133 male, 72 female, median gradient 48 mmHg, median EF: 61%). NYHA class, aortic valve area and valve calcification were worse in the 80+ group. Biological valve prostheses were implanted in 94.6% of the older and in 45.4% of the younger patients (p < 0.001). Perioperative complications occurred more often (p = 0.0188) in the 80+ group (86.5% experienced 1 or more complications) than in the 80- group (66.3%). Similarly, the MACE (Major Adverse Cardiovascular Events) rate was higher (p = 0.0448) in the 80+ group than in the 80- group. Bleeding occurred (p = 0.092) more often in younger (9.3%) than in older (0%) patients, while renal insufficiency was more frequent (p = 0.0164) in older (21.6%) than in younger patients (7.8 %). The 30-day mortality was higher (p = 0.0045) in older (21.6%) than in younger patients (5.8%). Multivariate analysis revealed an odds ratio for early death of 2.9 (CI 1.014-8.397) for patients older than 80 years. The late death rate within the first 5 years after surgery was comparable in both groups (80- group 24.4%, 80+ group 24.3%). Postoperative quality of life was significantly worse in the 80+ group in 4 out of 8 functions. Octogenarians undergoing AVR + CABG have a relatively high perioperative complication rate and mortality, but show a stable medium-term survival. The perioperative complication rate is higher in older than in younger patients, and the postoperative quality of life with regard to bodily functions is acceptable but significantly worse than that of younger patients.

Böning A ，Lutter G ，Mrowczynski W ，Attmann T ，Bödeker RH ，Scheibelhut C ，Cremer J ... -  《-》

Aortic valve replacement in octogenarians: risk factors for early and late mortality.

Melby SJ ，Zierer A ，Kaiser SP ，Guthrie TJ ，Keune JD ，Schuessler RB ，Pasque MK ，Lawton JS ，Moazami N ，Moon MR ，Damiano RJ Jr ... -  《-》

Quality-of-life in octogenarians one year after aortic valve replacement with or without coronary artery bypass surgery.

Folkmann S ，Gorlitzer M ，Weiss G ，Harrer M ，Thalmann M ，Poslussny P ，Grabenwoger M ... -  《-》

The stentless freestyle bioprosthesis: impact of age over 80 years on quality of life, perioperative, and mid-term outcome.

Ennker J ，Dalladaku F ，Rosendahl U ，Ennker IC ，Mauser M ，Florath I ... -  《-》

Early neurological complications after coronary artery bypass grafting and valve surgery in octogenarians.

Ngaage DL ，Cowen ME ，Griffin S ，Guvendik L ，Cale AR ... -  《EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY》