The Stentless Freestyle Bioprosthesis: Impact of Age Over 80 Years on Quality of Life, Perioperative, and Mid-Term Outcome

Abstract

Except for postoperative neurological complications, octogenarians receiving stentless bioprostheses had no increased risk of adverse perioperative and mid-term outcome in comparison to younger patients. As quality of life and life expectancy after AVR with stentless valves were equal to the general population, AVR with stentless bioprostheses should not be withheld from octogenarians.

The 30 Day Complication Rate After Aortic Valve Replacement with a Pericardial Valve in a Mainly Geriatric Population

“…The linearized rate for long-term prosthetic valve endocarditis was low and mostly under 1% per patient year (26,27,(32)(33)(34)(35)(36)(37)(38)(39). The most event free rates after 5 to 25 year were well over 90%.…”

“…The most event free rates after 5 to 25 year were well over 90%. This was true for mechanical heart valves (35,40,41) as well as for the different stented (30,42) and stentless tissue valves (27,36,43) as for homografts (8). No risk factors could be identified, although a previous endocarditis could arouse some suspicion.…”

“…The effect of age, however remained a matter for debate: atrial fibrillation did not occur more frequently in octogenarians after AVR (27). It seems that postoperative atrial fibrillation was preventable, at least in part.…”

“…If the LVEF is below 30%, life-long anticoagulation is required (25). Age also has been identified as an independent predictor (23)(24)(25)(26)(27). The age distribution of any given patient population should be made known to appreciate fully the effect of this factor.…”

Valve replacement in the elderly patients

“…On the other hand, this could be attributed to the relatively low number of patients in many studies ranging from 61-140. 4,7,9,15 On the other hand, the analyzed study populations could differ in their pre-operative risk factors. Therefore, an adequate method of analysis should be a risk-adjusted comparison of outcome variables between patients older and younger than 80 years by multi-variate regression methods.…”