Aortic Valve Replacement in Octogenarians With Prior Cardiac Surgery

Timek, Tomasz A.; Turfe, Zaahir; Hooker, Robert L.; Davis, Alan T.; Willekes, Charles L.; Murphy, Edward; Bove, Theodore J.; Heiser, John; Patzelt, Lawrence H.

doi:10.1016/j.athoracsur.2014.08.024

Cited by 12 publications

(5 citation statements)

References 30 publications

(31 reference statements)

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“…Results of SAVR in octogenarians are well documented but data on re‐sternotomies in octogenarians remains sparse 13 . Timek et al 14 reported a perioperative mortality of 1.6% in 3735 patients (mean age 83 ± 2 years) over 8 years with comparable long‐term survival (median survival – 7.8 years). Patients with another concomitant cardiac procedure (46%) had similar survival to those with Isolated redoSAVR.…”

Section: Discussionmentioning

confidence: 99%

Re‐sternotomy for aortic valve replacement in octogenarian patients in age of evolving transcatheter therapies

Luthra

Malvindi

Masraf

et al. 2022

Journal of Cardiac Surgery

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Background: The aim of this study was to analyze perioperative results and longterm survival of re-sternotomy for surgical aortic valve replacement (SAVR) in octogenarians in age of transcatheter therapies.Methods: This is a retrospective, single-center study (April 2000 to December 2019). Perioperative data were compared for re-sternotomy with isolated SAVR (Isolated redoSAVR) and re-sternotomy with SAVR and concomitant cardiac procedure (Associated redoSAVR). Regression analyses were performed to identify predictors of in-patient mortality. Hazard ratios and Kaplan-Meier survival curves were compared for groups.Results: There were 163 patients (Isolated redoSAVR; 69, Associated redoSAVR; 94). Emergency/salvage cases were excluded. The median age was 83 (81-85) years and the median logEuroSCORE was 19.2 (13.0-26.7)%. The follow-up was 4.2 ± 3.5 years.Inpatient mortality was 4.9% (1.4% vs. 7.4% for Isolated redoSAVR and Associated redoSAVR respectively, p = .08). TIA/stroke rate was 8% (9% vs. 7% for Isolated re-doSAVR and Associated redoSAVR, respectively, p = .78). COPD was a predictor of

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Section: Discussionmentioning

confidence: 99%

Re‐sternotomy for aortic valve replacement in octogenarian patients in age of evolving transcatheter therapies

Luthra

Malvindi

Masraf

et al. 2022

Journal of Cardiac Surgery

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“…Paravalvular regurgitation is reported more frequently in patients post TAVI [6,9,10]. Its presence may adversely affect long-term survival [6].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter versus Surgical Aortic Valve Replacement in High-risk Patients: A propensity-score matched analysis

Zweng

Shi

Palmer

et al. 2016

Heart, Lung and Circulation

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“…10 The reported mortality in octogenarians undergoing reoperative SAVR by Luthra et al 6 is 1.4% and is similar to the reported mortality of 1.6% by another study that specifically looked at this particular cohort. 11 This is much lower than the usually reported mortality in octogenarians 12 or during reoperative aortic valve surgery 13 and is perhaps due to a very careful case selection in these patients. These two studies 6,11 confirm that excellent results are possible even in challenging circumstances and highlight the need for and importance of multidisciplinary heart teams.…”

mentioning

confidence: 86%

“…11 This is much lower than the usually reported mortality in octogenarians 12 or during reoperative aortic valve surgery 13 and is perhaps due to a very careful case selection in these patients. These two studies 6,11 confirm that excellent results are possible even in challenging circumstances and highlight the need for and importance of multidisciplinary heart teams. Further evidence of careful selection with heart team involvement has been highlighted in a recent study that showed no mortality in octogenarians undergoing aortic valve replacements who were referred after a heart team consultation.…”

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confidence: 86%

Octogenarians needing reoperative aortic valve surgery—Does one size fit all?

Narayan

Dimagli

Angelini

2022

Journal of Cardiac Surgery

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Early and midterm outcomes, rather than long-term outcomes, are perhaps more relevant in octogenarians undergoing transcatheter aortic valve replacement (TAVR) or redo-surgical aortic valve replacement. Considering that early and midterm outcomes are similar with both the interventions, TAVR appears to be an attractive option in these patients. However, decision-making should consider other factors like presence of porcelain aorta, or severe primary mitral regurgitation among others that may influence the strategy to be adopted. The philosophy of shared decision making, and heart team consultation is, therefore, ever most relevant in these highrisk and vulnerable groups of patients. The recommendations rather than being

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Aortic Valve Replacement in Octogenarians With Prior Cardiac Surgery

Cited by 12 publications

References 30 publications

Re‐sternotomy for aortic valve replacement in octogenarian patients in age of evolving transcatheter therapies

Re‐sternotomy for aortic valve replacement in octogenarian patients in age of evolving transcatheter therapies

Transcatheter versus Surgical Aortic Valve Replacement in High-risk Patients: A propensity-score matched analysis

Octogenarians needing reoperative aortic valve surgery—Does one size fit all?

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