2019 Volume 65 Issue 2 Pages 157-165
Objective: Aortic valve stenosis (AS) is becoming more prevalent in the elderly population. The aim of this study was to determine if patients aged ≥80 years are at a higher risk of aortic valve replacement (AVR) for AS, with or without coronary artery bypass grafting (CABG), compared to their younger counterparts.
Materials and Methods: A retrospective review of 539 consecutive patients with AS who underwent AVR between August 2002 and December 2016 at Juntendo University Hospital was performed. These patients were divided into four groups by years of age: <60 (n=58), 60-69 (n=130), 70-79 (n=279), and ≥80 (n=126).
Results: Early mortality and postoperative major complications were similar among the age groups. Thus, an age ≥80 years was not an independent predictor for early mortality or morbidity. Early mortality was 3.1% in patients aged ≥80 years, compared with 0 to 3.5% in the younger age groups. Advanced age significantly and independently impacted prolonged length of stay (PLOS)(p=0.002) and non-home discharge rates (p=0.001). Recovery after AVR was significantly slower in patients aged ≥80 years than in the younger patients. Increasing age was an independent predictor of long-term mortality (p=0.002), but AVR in the very elderly patients was associated with a good late survival of 78% at 5 years.
Conclusions: AVR in patients aged ≥80 years can be performed with low postoperative mortality and morbidity, and excellent long-term survival. We recommend that indications of AVR for AS should not be based on age alone.
