Asian cardiovascular & thoracic annals · 2014
Aortic valve reconstruction using autologous pericardium for ages over 80 years.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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История · было → стало
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Ozaki Shigeyuki, Kawase Isamu, Yamashita Hiromasa, Uchida Shin, Nozawa Yukinari, Takatoh Mikio, Hagiwara So, Kiyohara Nagaki
Аннотация
BACKGROUND: We performed original aortic valve reconstruction using autologous pericardium; the feasibility for elderly patients is reviewed.
METHODS: From April 2007 through September 2011, aortic valve reconstruction was carried out in 86 patients over the age of 80 years. Twenty-seven patients were male and 59 were female. Mean age was 82.9 ± 2.5 years. Seventy-two patients had aortic stenosis and 14 had aortic regurgitation. Mean preoperative surgical annular diameter was 19.5 ± 2.5 mm. There were 80 (90.7%) cases of small aortic annulus. Mean preoperative logistic EuroSCORE was 22.9 ± 15.8.
RESULTS: Isolated aortic valve reconstructions were performed in 51 patients. Concomitant procedures included coronary artery bypass grafting in 6, hemiarch aortic replacements in 6, 9 maze procedures, and some combinations. No conversion to valve replacement was required. Mean follow-up was 1243 days. There were 3 hospital deaths due to noncardiac causes. No reoperation was needed. Survival at 56 months was 87.0%. No thromboembolic event occurred. Echocardiography 3.5 years after surgery revealed an average peak pressure gradient of 14.6 ± 3.8 mm Hg. No moderate or severe regurgitation was recorded.
CONCLUSIONS: Aortic valve reconstruction is feasible for patients older than 80 years, resulting in good hemodynamics and a better quality of life, without anticoagulation.
METHODS: From April 2007 through September 2011, aortic valve reconstruction was carried out in 86 patients over the age of 80 years. Twenty-seven patients were male and 59 were female. Mean age was 82.9 ± 2.5 years. Seventy-two patients had aortic stenosis and 14 had aortic regurgitation. Mean preoperative surgical annular diameter was 19.5 ± 2.5 mm. There were 80 (90.7%) cases of small aortic annulus. Mean preoperative logistic EuroSCORE was 22.9 ± 15.8.
RESULTS: Isolated aortic valve reconstructions were performed in 51 patients. Concomitant procedures included coronary artery bypass grafting in 6, hemiarch aortic replacements in 6, 9 maze procedures, and some combinations. No conversion to valve replacement was required. Mean follow-up was 1243 days. There were 3 hospital deaths due to noncardiac causes. No reoperation was needed. Survival at 56 months was 87.0%. No thromboembolic event occurred. Echocardiography 3.5 years after surgery revealed an average peak pressure gradient of 14.6 ± 3.8 mm Hg. No moderate or severe regurgitation was recorded.
CONCLUSIONS: Aortic valve reconstruction is feasible for patients older than 80 years, resulting in good hemodynamics and a better quality of life, without anticoagulation.
Предметные рубрики MeSH
Age FactorsAged, 80 and overAortic ValveAortic Valve InsufficiencyAortic Valve StenosisCardiac Surgical ProceduresFeasibility StudiesFemaleHemodynamicsHumansKaplan-Meier EstimateMalePericardiumQuality of LifePlastic Surgery ProceduresRetrospective StudiesRisk FactorsTime FactorsTransplantation, AutologousTreatment OutcomeUltrasonography