Document Detail


Mid term outcome and quality of life after aortic valve replacement in elderly people: mechanical versus stentless biological valves.
MedLine Citation:
PMID:  16020589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the benefit for patients older than 65 years of aortic valve replacement with stentless biological heart valves in comparison with mechanical valves.
DESIGN: Multiple regression analysis of a retrospective follow up study.
SETTING: Single cardiothoracic centre.
PATIENTS: Between 1996 and 2001, 392 patients with a mean age of 74 years underwent aortic valve replacement with stentless Freestyle bioprostheses or mechanical St Jude Medical prostheses.
MAIN OUTCOME MEASURE: Operative mortality and morbidity, postoperative morbid events, mid term survival, and New York Heart Association (NYHA) class improvement, and quality of life.
RESULTS: No significant differences were found between patients receiving stentless biological valves and patients receiving mechanical prostheses. However, analysis of subgroups showed that patients older than 75 years with mechanical valves had an increased risk of major bleeding events (p = 0.007). Patients requiring anticoagulation by means of coumarin had a twofold increased risk of an impaired emotional reaction (p = 0.052). However, for patients who received a mechanical valve for severe combined aortic valve disease a survival advantage (p = 0.045) and a decreased risk of prolonged ventilation (p = 0.001) was observed. On the other hand, patients receiving a stentless bioprosthesis had an increased risk of a prolonged stay in intensive care (p = 0.04) and stroke (p = 0.01) if they had severely reduced cardiac function (NYHA class IV).
CONCLUSIONS: Elderly people receiving stentless bioprostheses benefit emotionally because of the avoidance of coumarin. However, in patients with severe hypertrophied ventricles and extraordinary calcifications, stentless bioprostheses should be chosen with caution.
Authors:
I Florath; A Albert; U Rosendahl; T Alexander; I C Ennker; J Ennker
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  91     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-15     Completed Date:  2005-08-22     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1023-9     Citation Subset:  AIM; IM    
Affiliation:
Herzzentrum Lahr/Baden, Lahr, Germany. ines.florath@heart-lahr.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Valve*
Bioprosthesis*
Endocarditis / etiology,  mortality
Female
Follow-Up Studies
Heart Valve Diseases / mortality,  surgery*
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / methods,  mortality
Humans
Male
Postoperative Complications / etiology*,  mortality
Postoperative Hemorrhage / etiology,  mortality
Quality of Life*
Questionnaires
Reoperation
Retrospective Studies
Stroke / etiology,  mortality
Survival Analysis
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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