OC72 SURGICAL TREATMENT OF ISOLATED AORTIC STENOSIS IN OCTOGENARIAN PATIENTS: LONG-TERM RESULTS OF A CONSECUTIVE MONOCENTRIC SERIES

Abstract

Background and Aim: Aortic stenosis (Sao) is the most common cause of cardiac valve surgery in Europe. The aim of this study is to analyze the short- and long-term outcome of a consecutive population of octogenarian patients who underwent AVR for isolated severe Sao. Methods: Between January 2003 and December 2016, 270 consecutive patients (mean age = 83 ± 2 years, male = 36%) were operated on AVR for isolated Sao at our center. 28% of patients had symptoms of advanced heart failure (NYHA class III-IV), despite good left ventricular function (mean FE = 56 ± 11%). Long-term outcomes were analyzed by Kaplan-Meier. Potential predictors of hospital mortality and long-term outcomes were investigated by logistic regression and multivariate Cox analysis, respectively. Results: In most patients a biological prosthesis was implanted (90%). The mean time of CEC and aortic clamping were 69 ± 19 and 55 ± 15 minutes, respectively. As regards perioperative complications, the incidence of stroke, acute renal failure, mediastinitis and complete AV block (which required PM implantation) was 0.5%, 4.3%, 2.3% and 2.8% respectively. 30-day mortality was 2.5% (7 patients). The mean follow-up was 54 ± 36 months (range: 12–161). 85% of patients showed up in NYHA class I-II. Overall we recorded 70 deaths (25%), of which 39 (14%) due to cardiac cause. Conclusions: The surgical aortic valve replacement in octogenarian patients is an effective therapy, with excellent long-term results as a prognosis quoad vitam, with a good functional recovery and quality of life.