To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: DG DISPATCH - ACC: Cardiac Valve Operations Should Not Be Ruled Out In Older Patients URL: http://www.pslgroup.com/dg/1F544E.htm Doctor's Guide March 19, 2001
By Jill Stein Special to DG News
ORLANDO, FL -- March 19, 2001 -- Valve operations can be performed in patients 80 years of age or older with acceptable early morbidity and mortality, researchers report.
These procedures, with or without coronary artery bypass grafting, should be offered to patients in this age group with otherwise appropriate indications for surgery and, in particular, with preserved renal function, investigators announced here Sunday (March 18) at the 50th Annual Scientific Session of the American College of Cardiology.
The data were reported by Dr. Yan Katsnelson and associates from the Brigham and Women's Hospital in Boston, Massachusetts, and are drawn from a retrospective study of 409 consecutive patients.
All participants in this study were 80 years of age or older and underwent isolated or combined elective or emergency valve surgery over a recent 62-month period.
Aortic valve replacement surgery was performed in 246 (60 percent), mitral valve replacement surgery in 118 (29 percent) patients and double-valve replacement surgery in 45 (11 percent) patients. Concomitant coronary artery bypass grafts were done in about two-thirds of aortic, two-thirds of mitral valves and three-fourths of double valve operations.
Nearly two-thirds of patients had New York Heart Association class III to IV symptoms. About one-fourth of patients had a left ventricular ejection fraction less than 40 percent.
Thirty-one patients died, for an overall operative mortality rate of 7.6 percent. Preoperative renal failure and diabetes mellitus were predictive of early mortality. However, left ventricular function, reoperations or coronary bypass grafting were not predictive of early mortality.
While age itself was not a risk factor, patients 85 years of age or older had more neurologic events. While 135 (33 percent) patients had no postoperative complications, the median length of stay was only nine days and the median intensive care unit stay was two days.
The age of patients referred for cardiac surgery continues to increase with the increase in life expectancy, Dr. Katsnelson said. By the year 2010, it is expected that more than 12 million Americans will be 80 years of age or older. Heart disease is present in more than 50 percent of this population and accounts for more than 40 percent of all deaths in this age group.
The number of patients 80 years of age or older who are referred for valve surgery continues to grow and they are expected to become a major referral source in the next decade. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.