Old Age Alone is not a Limitation for Surgical Aortic Valve Replacement

pp. 472-477

Authors

  • Guillermo Vaccarino Cardiovascular Surgery Service, Hospital Universitario Austral https://orcid.org/0000-0003-2813-4425
  • Sergio Baratta Cardiology Service, Hospital Universitario Austral; Echocardiography Service, Hospital Universitario Austral https://orcid.org/0000-0002-8409-0757
  • Jorge Bilbao Cardiovascular Repair Service, Critical Care Unit, Hospital Universitario Austral https://orcid.org/0000-0003-0955-5507
  • Eduardo Martino Echocardiography Service, Hospital Universitario Austral
  • Renzo Melchiori Echocardiography Service, Hospital Universitario Austral
  • Gustavo Bastianelli Cardiovascular Surgery Service, Hospital Universitario Austral
  • Guillermo Gutiérrez Cardiovascular Surgery Service, Hospital Universitario Austral https://orcid.org/0000-0003-4532-3279
  • Manuel Clusa Cardiovascular Surgery Service, Hospital Universitario Austral
  • Alejandro Hita Cardiology Service, Hospital Universitario Austral; Echocardiography Service, Hospital Universitario Austral https://orcid.org/0000-0003-2794-0644

Keywords:

Aortic valve stenosis, Aortic valve replacement, Symptomatic aortic valve disease

Abstract

Background: Surgical aortic valve replacement (SAVR) is the reference treatment in patients with symptomatic severe aortic valve disease. However, according to international scores, transcatheter aortic valve implantation (TAVI) is currently an alternative in different risk patients, and some guidelines consider TAVI as a preferable procedure in elderly patients.

Objectives: The aim of this study was to assess SAVR morbidity and mortality risk and results in adult patients, classified according to age as >75 years or ≤75 years.

Methods: A retrospective study was performed on 228 consecutive patients undergoing SAVR between January 1, 2011 and December 31, 2020 for symptomatic severe aortic valve disease. Among the total number of patients operated on, 46 (16%) were >75 years (Group 1, G1) and 182 (84%) were ≤75 years (Group 2, G2). Patients with concomitant coronary heart disease, bacterial endocarditis or other associated valve diseases were excluded from the analysis.

Results: Group 1 patients had greater risk of surgical morbidity and mortality analyzed by validated risk scores: ArgenSCORE 1.55 (IQR 0.99-3.33) vs 1.08 (IQR 0.68-2.23), p = 0.02 and STS score 2.33 (IQR 1.57-3.23) vs. 0.94 (IQR 0.72-1.44), p = 0.0001, with respect to G2, while no significant differences were found for EuroSCORE II: 2.37 (IQR 1.19-3.61) vs. 1.83 (IQR 1.16-3.04), p = 0.2. Overall mortality was 1.7% (G1: 2.1% vs. G2: 1.6%, p=NS), with no perioperative stroke or acute myocardial infarction (AMI).

Conclusions: The low number of deaths, stroke and AMI observed suggests that the selected treatment for these patients was adequate, with excellent results and without significant differences between these two age groups.

Vaccarino GN, Baratta S, Bilbao J, Martino E, Melchiori R, Bastianelli G, Gutiérrez G, Clusa M, Hita A. Old Age Alone is not a Limitation for Surgical Aortic Valve Replacement. Rev Argent Cardiol 2021;89:472-477. http://dx.doi.org/10.7775/rac.v89.i6.20457

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Published

2025-03-11

Issue

Rev Argent Cardiol 2021 Vol. 89 Issue. 6

Section

ORIGINAL ARTICLES

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Copyright (c) 2021 Argentine Journal of Cardiology

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