Abstract
Background and Aim. While aortic valve replacement for aortic stenosis can be performed safely in elderly patients, there is a need for hemodynamic and quality of life evaluation to determine the value of aortic valve replacement in older patients who may have age-related activity limitation. Materials and Methods. We conducted a prospective evaluation of patients who underwent aortic valve replacement for aortic stenosis with the Hancock II porcine bioprosthesis. All patients underwent transthoracic echocardiography (TTE) and completed the RAND 36-Item Health Survey (SF-36) preoperatively and six months postoperatively. Results. From 2004 to 2007, 33 patients were enrolled with an average age of 75.3 ± 5.3 years (24 men and 9 women). Preoperatively, 27/33 (82%) were New York Heart Association (NYHA) Functional Classification 3, and postoperatively 27/33 (82%) were NYHA Functional Classification 1. Patients had a mean predicted maximum V O2 (mL/kg/min) of 19.5 ± 4.3 and an actual max V O2 of 15.5 ± 3.9, which was 80% of the predicted V O2. Patients were found to have significant improvements (P ≤ 0.01) in six of the nine SF-36 health parameters. Conclusions. In our sample of elderly patients with aortic stenosis, replacing the aortic valve with a Hancock II bioprosthesis resulted in improved hemodynamics and quality of life.
Highlights
Aortic valve replacement (AVR) in elderly patients can be performed with excellent results and can improve survival when compared with medical therapy for patients with aortic stenosis [1,2,3]
Little is known regarding postoperative recovery and subsequent quality of life (QOL) in patients who undergo either isolated AVR or AVR associated with other procedures such as coronary artery bypass grafting (CABG)
We evaluated aortic valve replacement with the Hancock II porcine bioprosthesis in elderly patients with aortic stenosis with regard to symptom improvement and quality of life, exercise tolerance, and prosthetic hemodynamic performance
Summary
Aortic valve replacement (AVR) in elderly patients can be performed with excellent results and can improve survival when compared with medical therapy for patients with aortic stenosis [1,2,3]. We used echocardiography (ECHO), bicycle cardiopulmonary exercise testing (CPET), and QOL surveys to evaluate elderly patients after AVR for aortic stenosis with the Hancock II porcine bioprosthesis (Medtronic Inc., Minneapolis, MN). We conducted a prospective evaluation of patients who underwent aortic valve replacement for aortic stenosis with the Hancock II porcine bioprosthesis. In our sample of elderly patients with aortic stenosis, replacing the aortic valve with a Hancock II bioprosthesis resulted in improved hemodynamics and quality of life
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