An analysis of isolated aortic valve surgery and combined procedures in patients over 70 years of age.

Abstract

Ninety-four patients over the age of 70 years were submitted to 95 operations for aortic valve disease. Seventy-seven patients had isolated aortic valve operations and a further 17 underwent additional procedures. The hospital mortality for the whole group was 15.7%. The actuarial five year survival was 66%. Concomitant coronary revascularization increased the perioperative risk. Myocardial protection by cold crystalloid cardioplegia improved results reducing the perioperative mortality for AVR alone from 21.7 to 11.1%. We believe that these patients should not be denied operative intervention since worthwhile improvement generally ensues. Coronary artery grafting can be hazardous. Bioprostheses inserted with myocardial protection favours surgery over continued medical management which offers little for these elderly symptomatic patients.