Aortic valve replacement in patients over the age of sixty.

Abstract

Twenty-nine consecutive patients over the age of 60 with isolated aortic valvular disease, who had undergone aortic valve replacement with the Bjork-Shiley tilting disc valve prosthesis, were subjected to a clinical, angiographic and haemodynamic follow-up study. Before surgery, this material was characterized by long histories of deterioration, pre-dominance of male patients and patients with aortic stenosis, marked cardiac enlargement and by impaired functional capacity, working capacity and pump function of the left ventricle. Congestive heart failure and pulmonary hypertension were uncommon in these elderly patients, who were incapacitated by marked obstruction and/or severe regurgi-tation.The main effect of aortic valve replacement was a shift of the central circulation to a more normokinetic type, an increase in stroke volume and a decrease in the filling pressure of the left ventricle. In patients with aortic stenosis, the systolic pressure of the left ventricle was normalized and stroke work marke...