AORTIC-VALVE REPLACEMENT IN PATIENTS 80 YEARS OF AGE AND OLDER - SURVIVAL AND CAUSE OF DEATH BASED ON 1100 CASES - COLLECTIVE RESULTS FROM THE UK HEART-VALVE REGISTRY

Background Aging of the population and advances in preoperative and po stoperative care are reflected in an increasing number of patients gre ater than or equal to 80 years of age undergoing aortic valve replacem ent (AVR) in the United Kingdom. The present study presents data on po stoperative 30-day mortality, actuarial survival, and cause of death b ased on a large collective patient population. Methods and Results Dat a were extracted from the UK Heart Valve Registry. From January 1986 t o December 1995, 1100 patients greater than or equal to 80 years of ag e underwent AVR and were reported to the registry. Six hundred eleven patients (55.5%) were women. The mean follow-up time was 38.9 months. The 30-day mortality was 6.6%. Of the 73 early deaths, 42 were due to cardiac reasons. The actuarial survival was 89%, 79.3%, 68.7%, and 45. 8% at 1, 3, 5, and 8 years, respectively. After the first 30 postopera tive days, 144 of the 205 deaths were due to noncardiac reasons. Malig nancy, stroke, and pneumonia were the most common causes of late death . Bioprosthetic valves were implanted in 969 patients (88%) and mechan ical valves in 131 (12%) patients. There was no difference in early mo rtality and actuarial survival between the mio groups (P>.05). Conclus ions The above results suggest that under the selection criteria for A VR currently applied in the United Kingdom, patients greater than or e qual to 80 years of age show a satisfactory early postoperative outcom e and moderate medium-term survival benefit.