Kesavan S, Iqbal A, Khan Y, Hutter J, Pike K, Rogers C, Turner M, Townsend M, Baumbach A. Risk profile and outcomes of aortic valve replacement in octogenarians. World J Cardiol 2011; 3(11): 359-366 [PMID: 22125671 DOI: 10.4330/wjc.v3.i11.359]
Corresponding Author of This Article
Dr. Andreas Baumbach, Consultant Cardiologist, Honorary Reader in Cardiology, Department of Cardiology, Bristol Heart Institute and University of Bristol, Bristol BS2 8HW, United Kingdom. andreas.baumbach@uhbristol.nhs.uk
Article-Type of This Article
Original Article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Nov 26, 2011; 3(11): 359-366 Published online Nov 26, 2011. doi: 10.4330/wjc.v3.i11.359
Risk profile and outcomes of aortic valve replacement in octogenarians
Sujatha Kesavan, Aamer Iqbal, Yusra Khan, Jonathan Hutter, Katie Pike, Chris Rogers, Mark Turner, Mandie Townsend, Andreas Baumbach
Sujatha Kesavan, Academic Tutor and Research Fellow in Cardiology, University of Bristol and Bristol Heart Institute, Bristol BS2 8HW, United Kingdom
Aamer Iqbal, Yusra Khan, Medical students, University of Bristol, Bristol BS2 8HW, United Kingdom
Jonathan Hutter, Clinical Lead and Consultant Cardiothoracic Surgeon, University of Bristol and the Bristol Heart Institute, Bristol BS2 8HW, United Kingdom
Katie Pike, Chris Rogers, Clinical Trials Evaluation Unit, Bristol Heart Institute, Bristol BS2 8HW, United Kingdom
Mark Turner, Mandie Townsend, Consultant Cardiologist, University of Bristol and the Bristol Heart Institute, Bristol BS2 8HW, United Kingdom
Andreas Baumbach, Honorary Reader in Cardiology and Consultant Cardiologist, Bristol Heart Institute and University of Bristol, Bristol BS2 8HW, United Kingdom
Author contributions: Kesavan S and Baumbach A were instrumental in study conception and design, acquisition of data and writing of the paper; Turner M, Hutter J and Townsend M provided advice, input and helped with the revision and drafting of the manuscript; Iqbal A and Khan Y performed data entry; Pike K and Rogers C provided statistical support for the project.
Correspondence to: Dr. Andreas Baumbach, Consultant Cardiologist, Honorary Reader in Cardiology, Department of Cardiology, Bristol Heart Institute and University of Bristol, Bristol BS2 8HW, United Kingdom. andreas.baumbach@uhbristol.nhs.uk
Telephone: +44-117-3426573 Fax: +44-117-3425968
Received: July 6, 2011 Revised: August 19, 2011 Accepted: August 26, 2011 Published online: November 26, 2011
Abstract
AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR).
METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Infirmary. Demographics, acute outcomes, length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were defined: LES ≥ 15 (n = 80) and LES < 15 (n = 193).
RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identified a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR.
CONCLUSION: It may be better treated with transcatheter aortic valve implantation.
