Immediate and medium-term results of aortic valve replacement with biological prosthesis in elderly patients: experience of one center

Abstract

Objective. To analyze the immediate and medium-term results of prosthetics of the aortic valve (AV) using biological prosthesis in elderly patients.
 Material and methods. The study included 198 patients with AV pathology [85 men (42.9 %)/113 women (57.1 %)]. The median age was 70 [66–73] years. There were 175 (88.4 %) patients with sclerodegenerative AV, 5 (2.5 %) – with infectious endocarditis and 30 patients (15.2 %) had bicuspid AV.
 Results. The hospital mortality was 4.5 %. The causes of mortality were multiple organ failure syndrome, in 1 case – developed peritonitis. In 14 patients (7.1 %) there was a rhythm disturbance in the form of AF, in 9 (4.5 %) – a complete AV block, in connection with which a permanent pacemaker was implanted. Four patients (2 %) underwent resternotomy for bleeding. Two patients (1 %) underwent pericardiocentesis. 8 (4 %) patients developed a stroke. No wound complications were detected. In the long-term period, 31 patients died. The causes of mortality were the following: cardiovascular diseases – 13 patients, malignant neoplasms – 5 patients, gastrointestinal diseases – 2, urinary system disease – 1 patient, COVID-19 – 1 patient, unknown cause – 9 patients. Thus, the five-year survival rate after the surgery was 63 %, respectively. During the follow-up period, 2 patients (2.9 %) underwent repeated intervention on AV.
 Conclusions. The five-year freedom from re-operation was 97.1 %. The five-year survival rate was 63 % due to the presence of a history of severe concomitant pathology as well as the middle age of patients 70 years.