Frailty after aortic valve replacement (AVR) in octogenarians

Maillet, J; Somme, Dominique; Hennel, Elisabeth; Lessana, A; Saint-Jean, Olivier; Brodaty, D

doi:10.1016/j.archger.2008.03.010

Cited by 41 publications

(37 citation statements)

References 26 publications

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“…25 However, in cohort 1, stroke rates were similar for both groups (transapical, 2.6%; transfemoral, 2.4%) and comparable to those reported for conventional AVR 6,26 and other contemporary TAVI series. 16,27 One has to be careful when interpreting this lack of difference because of the different stroke risk profiles, particularly the incidence of carotid artery stenosis.…”

Section: Thomas Et Al Source Registry Of Transcatheter Avisupporting

confidence: 65%

Thirty-Day Results of the SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry

Thomas

Schymik²,

Walther³

et al. 2010

Circulation

773

162

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Background-Transcatheter aortic valve implantation was developed to mitigate the mortality and morbidity associated with high-risk traditional aortic valve replacement. PϽ0.001). Therefore, these groups are considered different, and outcomes cannot be compared. Overall short-term procedural success was observed in 93.8%. The incidence of valve embolization was 0.3% (nϭ3), and coronary obstruction was reported for 0.6% (nϭ6 cases). Incidence of stroke was 2.5% and similar for both procedural approaches. Thirty-day mortality was 6.3% in transfemoral patients and 10.3% in transapical patients. The occurrence of vascular complications was not a predictor of Ͻ30-day mortality in the transfemoral population. Conclusion-Technical proficiency can be learned and adapted readily as demonstrated by the short-term procedural success rate and low 30-day mortality rates reported in the SOURCE Registry. Specific complication management and refinement of patient selection are needed to further improve outcomes. (Circulation. 2010;122:62-69.)

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Section: Thomas Et Al Source Registry Of Transcatheter Avisupporting

confidence: 65%

Thirty-Day Results of the SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry

Thomas

Schymik²,

Walther³

et al. 2010

Circulation

773

162

View full text Add to dashboard Cite

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“…Kolh et al 12 interviewed 61 long-term survivors of AVR and found that 92% of patients believed that having heart surgery at age Ͼ80 was a "good choice," with 88% of patients feeling "as good or better" than they had before surgery. Additionally, Maillet et al 34 10 found that 84.4% (27 of 32) of early deaths were related to cardiac causes. In their series, 427 patients survived the 30-day postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival of the Very Elderly Undergoing Aortic Valve Surgery

et al. 2009

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Background— Increasing numbers of the very elderly are undergoing aortic valve procedures. We describe the short- and long-term survivorship for this cohort. Methods and Results— We conducted a cohort study of 7584 consecutive patients undergoing open aortic valve surgery without (51.1%; AVR) or with (48.9%; AVR + CABG) concomitant coronary artery bypass graft surgery between November 10, 1987 through June 30, 2006. Patient records were linked to the Social Security Administration’s Death Master File. Survivorship was stratified by age and concomitant CABG surgery. During 39 835 person-years of follow-up, there were 2877 deaths. Among AVR, there were 3304 patients <80 years of age, 419 patients 80 to 84 years, and 156 patients ≥85 years (24 patients >90 years). Among AVR+CABG patients, there were 2890 patients <80 years of age, 577 patients 80 to 84 years, and 238 patients ≥85 years (22 patients >90 years). Median survivorship for patients undergoing isolated AVR was 11.5 years (<80 years), 6.8 years (80 to 84 years), 6.2 years (≥85 years); for patients undergoing AVR+CABG, median survivorship was 9.4 years (<80 years), 6.8 years (80 to 84 years), and 7.1 years (≥85 years). Among both procedures, adjusted survivorship was significantly different across strata of age ( P <0.001). These findings are similar to life expectancy of the general population from actuarial tables: 80 to 84 years (7 years) and ≥85 years (5 years). Conclusions— Survivorship among octogenarians is favorable, with more than half the patients surviving more than 6 years after their surgery. Concomitant CABG surgery does not diminish median survivorship among patients >80 years of age.

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“…These findings might be accounted for by the fact that our participants had recently undergone a cardiac operation. Indeed, elective cardiac surgery is aimed at increasing life expectancy, and, which might be even more important for very old patients [26], at improving quality of life and independence through the relief of limiting symptoms, such as chest pain, shortness of breath or dysrhythmias [27]. However, elderly patients frequently show a slower and more complicated recovery after cardiac surgery [12,13].…”

Section: Generalizabilitymentioning

confidence: 99%

Effects of a structured physical activity intervention on measures of physical performance in frail elderly patients after cardiac rehabilitation: a pilot study with 1-year follow-up

et al. 2011

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The objective of this prospective randomized controlled study was to compare the long-term effects of a structured physical activity intervention with those of aerobic exercises alone, in a cohort of elderly patients who had undergone elective cardiac surgery, and who were classified as frail at the end of rehabilitation based on their Short Physical Performance Battery (SPPB) score. At the end of rehabilitation, 140 frail elderly patients were randomly allocated either to the intervention group (IG) or to the control group (CG). CG participants received the usual aerobic exercise prescription, while IG participants were also taught additional exercises for strength, flexibility, balance and coordination. The improvement in SPPB score after 1 year was the outcome of the study. IG showed a significant improvement in SPPB score (9.0 ± 1.1 vs. 7.7 ± 1.4, p \ 0.001), while no significant change was found in CG (7.7 ± 1.6 vs. 7.6 ± 1.5, p = 0.252). IG also showed a significantly higher proportion of participants who improved their SPPB score of at least 1 point (70 vs. 37%, p \ 0.001). In conclusions, our structured physical activity intervention significantly improves the SPPB score in frail elderly patients who have undergone elective cardiac surgery. An intervention that improves the SPPB score might delay the occurrence of mobility disability.

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Frailty after aortic valve replacement (AVR) in octogenarians

Cited by 41 publications

References 26 publications

Thirty-Day Results of the SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry

Thirty-Day Results of the SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry

Long-Term Survival of the Very Elderly Undergoing Aortic Valve Surgery

Effects of a structured physical activity intervention on measures of physical performance in frail elderly patients after cardiac rehabilitation: a pilot study with 1-year follow-up

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