Aortic Valve Replacement with and without Coronary Artery Bypass Graft Surgery in Octogenarians: Is It Safe and Feasible?

Abel, Nicole; Rogal, Gary; Burns, Paul; Saunders, Craig R.; Chamberlain, Ronald S.

doi:10.1159/000346153

Cited by 17 publications

(10 citation statements)

References 26 publications

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“…This is also in keeping with more recent data attesting to the safety of coronary revascularization at AVR even in high-risk elderly patients. 18,19 Our findings also clearly demonstrate superior 5-and 8-year survival rates in patients with CABG versus medical management for coexistent CAD at index AVR. After adjusting for the confounding effects of older age, female sex, peripheral vascular disease, reduced ejection fraction, diabetes mellitus, and NYHA class III to IV, CABG was independently associated with a more than one-third reduction in the risk of late all-cause mortality.…”

Section: Discussionsupporting

confidence: 59%

The prognostic impact of concomitant coronary artery bypass grafting during aortic valve surgery: Implications for revascularization in the transcatheter era

Thalji

Suri

Daly

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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In patients undergoing AVR with coexistent CAD, concomitant CABG reduces risk of late death by more than one-third, without augmenting operative mortality. This survival advantage persists in moderate (50% to 70%) and severe (>70%) CAD. These findings underline the prognostic importance of revascularization in this population and should influence decisions regarding revascularization strategy in patients undergoing transcatheter valve therapy.

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Section: Discussionsupporting

confidence: 59%

The prognostic impact of concomitant coronary artery bypass grafting during aortic valve surgery: Implications for revascularization in the transcatheter era

Thalji

Suri

Daly

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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“…Abel ve ark. miyokardiyal revaskülarizasyon geçiren ileri yaşlı hastalardaki mortalitenin genç hastalarda görülenden 2 kat daha fazla olduğunu bildirmiştir (9). Güncel çalışmalarda mortalitenin özellikle 80 yaş ve üzeri olan hastalarda yüksek olduğunu ortaya koymuştur (10).…”

Section: Discussionunclassified

Seksen Yaş ve Üzeri Hastalarda Koroner Arter Bypass Cerrahisine Ek Olarak Uygulanan Prosedürler Operasyonun Riskini Arttırır mı?

Erkanlı¹,

Aksu²,

Ünal³

et al. 2014

Haseki

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ÖzetAmaç: Günümüzde normal yaşam süresinin uzaması ile ileri yaşta koroner bypass cerrahisi ve ek cerrahi işlem uygulamaları artmaktadır. Biz çalışmamızda 80 yaş ve üzeri hastalarda uygulanan ek cerrahi işlemlerin erken dönem etkilerini inceledik. Yöntemler: Kliniğimizde Eylül 2009 ve Haziran 2012 tarihleri arasında koroner bypass cerrahisine giden 80 yaş ve üzeri (82.86±2.91) 29 olgu geriye gönük olarak değerlendirildi. Olgular 2 gruba ayrıldı: Grup 1 koroner arter bypass (CABG) işlemi uygulananlar, Grup 2 ise CABG ve ek kardiyak işlem yapılan olgular. Her iki grup risk faktörleri ve postoperatif bulgular istatistik yöntemleri kullanılarak karşılaştırıldı. Bulgular: Üç olguya CABG öncesi karotid endarterektomi yapıldı. Bir hastaya CABG ile aort kapak replasmanı, 1 hastaya CABG ile mitral kapak replasmanı + triküspit kapak tamiri yapıldı. İki hastaya CABG ve mitral kapak tamiri uygulandı.Bir hastaya ise abdominal aort ön duvar rüptürüne bağlı abdominal aort replasmanı eş zamanlı uygulandı. Ayrıca 1 olguya da CABG ve asendan aorta suprakoroner greft replasmanı yapıldı. Euroscore değeri 5.06 (2.07-13,24) bulundu. 30 günlük mortalite oranı %6.8 (n:2) olarak tespit edildi. Ayrıca hastane yatış süresi ise 10.45±8.18 (6-13.5) gün olarak bulundu. Sonuç: Seksen yaş ve üzeri hastalarda koroner bypass cerrahisi kabul edilebilir mortalite riskiyle tercih edilen tedavi şeklidir. Yaşın ilerlemesi ile gelişen ek işlem gereksinimi operasyon riskini arttırsa da koroner bypass cerrahisine ek kardiyak işlemler güvenilir şekilde uygulanabilir. (Ha se ki T›p Bül te ni 2014; 52: 14-8) Anahtar Kelimeler: Koroner bypass cerrahisi, ek operasyon, 80 yaş Abs tractAim: In association with increasing life expectancy, the number of elderly individuals undergoing coronary bypass grafting (CABG) and additional cardiac surgical procedures are increasing. In this study, we evaluated the effects of additional cardiac procedures and preoperative risk factors for postoperative mortality and morbidity in patients 80 years of age and older.

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“…However, advanced age was not an independent risk predictor of early mortality. Both Abel et al 12) and Thourani et al 7) reported similar results.…”

Section: Early Mortalitymentioning

confidence: 55%

Early and Late Outcome Including Postoperative Recovery of Patients Aged 80 Years and Older Undergoing Aortic Valve Replacement for Aortic Stenosis

Machida

Kuwaki

Endo

et al. 2019

Juntendo Medical Journal

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Objective: Aortic valve stenosis (AS) is becoming more prevalent in the elderly population. The aim of this study was to determine if patients aged ≥80 years are at a higher risk of aortic valve replacement (AVR) for AS, with or without coronary artery bypass grafting (CABG), compared to their younger counterparts. Materials and Methods:A retrospective review of 539 consecutive patients with AS who underwent AVR between August 2002 and December 2016 at Juntendo University Hospital was performed. These patients were divided into four groups by years of age: < 60 (n = 58), 60-69 (n = 130), 70-79 (n = 279), and ≥80 (n = 126). Results:Early mortality and postoperative major complications were similar among the age groups. Thus, an age ≥80 years was not an independent predictor for early mortality or morbidity. Early mortality was 3.1% in patients aged ≥80 years, compared with 0 to 3.5% in the younger age groups. Advanced age significantly and independently impacted prolonged length of stay (PLOS)(p = 0.002) and non-home discharge rates (p = 0.001). Recovery after AVR was significantly slower in patients aged ≥80 years than in the younger patients. Increasing age was an independent predictor of long-term mortality (p = 0.002), but AVR in the very elderly patients was associated with a good late survival of 78% at 5 years.Conclusions: AVR in patients aged ≥80 years can be performed with low postoperative mortality and morbidity, and excellent long-term survival. We recommend that indications of AVR for AS should not be based on age alone.

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Aortic Valve Replacement with and without Coronary Artery Bypass Graft Surgery in Octogenarians: Is It Safe and Feasible?

Cited by 17 publications

References 26 publications

The prognostic impact of concomitant coronary artery bypass grafting during aortic valve surgery: Implications for revascularization in the transcatheter era

The prognostic impact of concomitant coronary artery bypass grafting during aortic valve surgery: Implications for revascularization in the transcatheter era

Seksen Yaş ve Üzeri Hastalarda Koroner Arter Bypass Cerrahisine Ek Olarak Uygulanan Prosedürler Operasyonun Riskini Arttırır mı?

Early and Late Outcome Including Postoperative Recovery of Patients Aged 80 Years and Older Undergoing Aortic Valve Replacement for Aortic Stenosis

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