AORTIC-VALVE REPLACEMENT IN PATIENTS OLDER THAN 85 YEARS - OUTCOMES AND THE EFFECT ON THEIR QUALITY-OF-LIFE

Purpose The aim of this study was to investigate the outcome of aortic valve replacement (AVR) and the effect on quality of life in patients aged over 85 who had symptomatic aortic stenosis. Methods We performe d a retrospective analysis of 21 patients, aged 85-91 years (mean age 86.5), who underwent AVR, 10 of whom underwent concomitant coronary ar tery bypass grafting (CABG) between 1989 and 1995. All patients were c ategorized as New York Heart Association (NYHA) functional class III a nd IV. A questionnaire was used to evaluate heart symptoms and quality of life among the 13 patients who were alive at follow-up (9-83 month s). Results Eighteen patients were categorized as NYHA functional clas s I and II for 1 year (9 months for one patient) after AVR. Three pati ents, all undergoing concomitant CABG, died early. The overall 1-, 2- and 3-year actuarial survival rate was 85%, 64% and 53% (among the pat ients undergoing only AVR the figures were 100%, 100% and 85%). Follow -up questionnaire results showed an improvement in the patients' sympt oms of heart disease, dyspnea (P = 0.017) and angina (P = 0.03). An im provement in the patients' physical functioning (P = 0.025), satisfact ion with physical ability (P = 0.005), sleep (P = 0.025), health statu s (P = 0.025) and perception of general health (P = 0.005) was also ob served. Conclusions Our results show that AVR can be performed on pati ents greater than or equal to 85 years of age or older, with an improv ement in heart symptoms and quality of life. Coronary Artery Dis 9:373 -380 (C) 1998 Lippincott Williams & Wilkins.