Abstract
The aim of the present study was to investigate early and late results of the aortic valve preservation surgery (AVPS) through rough-hewing, demineralization and commissurotomy of the aortic valve (AV) in aortic stenosis (AS) at elderly people. Thirty-two patients operated for pure AS, older than 65 years-old were studied at InCor FMUSP. Early and late results, clinical (ambulatory and phone interview) and echocardiographic follow-up were investigated. Actuarial and event-free survival analysis was done using the Kaplan-Meier method. Four patients (15.4%) had presented de novo AV stenosis. Five patients had progressed to moderate and two to serious aortic regurgitation. Demineralization, commissurotomy and rough-hewing were realized in 28, 20 and 16 patients, respectively. Nine patients had presented serious postoperative complications (28.1%). Two hospital-acquired pneumonia sepsis and five late deaths had occurred. Postoperative NYHA functional status were 70.5%, 17.6%, 5.8% and 5.8% for functional classes I, II, III and IV, respectively. Actuarial eight-year survival rate was 66.9 +/- 12.1%. Eight-year free thromboembolism and endocarditis rate were 90.9 +/- 8.7% and 100%, respectively. Aortic valve preservation surgery at the aged with AS was revealed a low morbidity and mortality procedure and presented an eight-year acceptable survival rate and functional status improvement among the studied series of patients.
Highlights
Aortic stenosis (AS) is a disease that is relatively prevalent in the elderly (2.9%) [1]
The aim of this study is to present immediate and longterm results of aortic valve (AV) preservation surgery using reshaping and decalcification, as well as the results of AV commissurotomy in the elderly
All patients were over 65 years old, and the decision to go through with AV repair was decided by the surgeon
Summary
Aortic stenosis (AS) is a disease that is relatively prevalent in the elderly (2.9%) [1]. In Brazil, Neves et al and, more recently, Mendonça et al, published their experiences with reconstructive surgery of the aortic valve, for aortic insufficiency, with good results in both studies [3,4]
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