MedicineCardiologySurgeryCardiothoracic SurgeryHemodynamic ManagementPerioperative Outcomes ResearchAortic SurgeryAortic Valve DiseaseCardiac Valve SurgeryHeart FailureMyocardial ProtectionSurgical Valve ReplacementActuarial Survival AnalysisAortic Valve Disease PrognosisCold Blood CardioplegiaIn-hospital MortalityOverall MortalityPerioperative Myocardial Protection
Between 1970 and 1979 50 patients over the age of seventy years underwent aortic valve replacement. The overall hospital mortality was 14% but has been reduced to 5% following the introduction of cold cardioplegia for myocardial protection. Actuarial survival curves predict a 60% five year survival. Whilst all patients considered for surgery were severely limited in terms of effort tolerance, only 5% of the survivors remain in New York Heart Association functional class III or IV. In conclusion aortic valve replacement may be safely performed in septagenarians and results in increased longevity and quality of life.