Aortic valvular replacement in octogenarians. Short-term and mid-term results in 140 patients

Aortic valvular replacements were performed between 1986 and 1995 at Rouen University Hospital on 140 octogenarians (52 male and 88 female). Pure or p redominant aortic stenosis was present in 115 patients, 25 had associated a ortic stenosis and insufficiency or predominant aortic insufficiency. Signi ficant coronary lesions were present in 42% of patients. An isolated aortic valvular replacement was performed in 74% of patients, associated with a b ypass in 23% and a bioprosthesis was used in 90%. Valvular lesions were mai nly caused by Monckeberg disease. Thirteen operative deaths occurred (9.3%) . Functional recovery was satisfactory in 78%, mean hospital stay was 12 da ys. All well-known risk factors for aortic valvular replacement: age, coron ary lesions, cardiac insufficiency, impaired ejection fraction and aortic i nsufficiency, led to an increase in operative mortality but were not statis tically significant. Late mortality occurred in 28 patients, 99 patients ar e still alive at 4-91 months after surgery, The actuarial survival curve sh ows a 56.5% probability of surviving 5 years. Eighty per cent of survivors are able to live independently at home. (C) 1999 Published by Elsevier Scie nce Ltd. All rights reserved.