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01-01-2014 | Original Article

The optimal timing of aortic valve replacement in elderly patients with severe aortic stenosis

Authors: Akira Marumoto, Yoshinobu Nakamura, Yuichiro Kishimoto, Munehiro Saiki, Motonobu Nishimura

Published in: Surgery Today | Issue 1/2014

Abstract

Purpose

The elderly population with severe aortic stenosis (AS) requiring aortic valve replacement (AVR) is increasing. The optimal timing of AVR in these patients has been under discussion.

Methods

We retrospectively reviewed the data from severe AS patients (n = 84) who underwent AVR with/without concomitant procedures from 2005 to 2010. The symptom status, preoperative data, operative outcome, late survival and freedom from cardiac events were compared between elderly patients (age ≥80 years [n = 31]) and younger patients (age <80 years [n = 53]).

Results

The operative mortality in elderly patients (3.2 %) and younger patients (3.8 %) was comparable. The symptoms in elderly patients were more severe and hospitalized heart failure (HF) was more frequently noted as the primary symptom (p = 0.017). Patients with and without hospitalized HF differed significantly in late survival and freedom from cardiac events (p = 0.001), but advanced age had no significant effect. The results of a Cox proportional hazards analysis revealed that hospitalized HF was a significant predictor for cardiac events after AVR, irrespective of age (hazard ratio 6.93, 95 % confidence interval 1.83–26.26, p < 0.004).

Conclusions

In elderly patients with severe AS, surgery should be recommended even in the presence of minimal symptoms and should be performed before the onset of life-threatening HF.

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Title: The optimal timing of aortic valve replacement in elderly patients with severe aortic stenosis
Authors: Akira Marumoto
Yoshinobu Nakamura
Yuichiro Kishimoto
Munehiro Saiki
Motonobu Nishimura
Publication date: 01-01-2014
Publisher: Springer Japan
Published in: Surgery Today / Issue 1/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-012-0487-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The optimal timing of aortic valve replacement in elderly patients with severe aortic stenosis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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