Aortic valve replacement after 80 years of age: Short and medium-term results in a series of 140 patients

One hundred and forty aortic valve replacements (AVR) performed between 198 6 and 1995 at Rouen University Hospital in octogenarians (52 men and 88 wom en), including 9 emergency procedures, were analysed. One hundred and fifte en patients had pure aortic stenosis, 25 had mixed aortic valve disease wit h mainly aortic incompetence. The surgical decision was taken by the patien t with the surgeon after an interview, in order to exclude too handicapped or undecided patients. Significant coronary artery disease was observed in 42% of cases. Isolated AVR was undertaken in 74% of cases and associated coronary bypass surgery i n 23% of cases. Bioprostheses were used in 90% of cases. The valvular lesio ns were predominantly those of Monckeberg disease. The operative mortality was of 13 patients (9.3%). Functional recovery was satisfactory in 78% of cases; the average duration of the hospital stay was 12 days. All known risk factors for AVR : age, coronary lesions, cardiac f ailure, low ejection fraction, aortic regurgitation, were associated with i nsignificant increases in mortality. The secondary mortality was of 28 pati ents : 99 patients are still alive 4 to 91 months after surgery. The actuar ial survival graph showed a 56.5% probability of 5 year survival. Eighty pe r cent of survivors live at home without loss of autonomy.