THE INFLUENCE OF AGE ON THE RESULTS OF MECHANICAL VALVE REPLACEMENT IN PATIENTS WITH ACQUIRED VALVULAR HEART DISEASE

Abstract

In order to know a relation between therapeutic results of mechanical valve replacement and the age at the operation, patients with acquired valvular heart disease were comparatively studied on their pre- and postoperative states by age group-According to age at the time of operation, the patients were classified into 3 groups; Group A: under 40, group B: from 40 to 59, and group C: over 60 years old-When analysed preoperative states, Group A and C had nonrheumatic lesions in higher rate, but no difference in other various values was found among the 3 groups. The operative mortality rate, days for ICU stay, postoperative incidence of cardiac or other organ failure, and the actuarial postoperative survial rate were also similar in all 3 groupsl Postoperative improvements in NYHA class were observed in group C as well as in group A and B. Systemic thromboembolism was not prevalent in group A and C, whereas the incidence of thromboembolism was 0.77%/patient-year in group B. Cerebral bleeding resulting from the reversed effect of anticoagulant therapy especially occurred in patients of group C, thus the incidence of this complication was 2.97%/patient-year in this group. In conclusion, though the main causes of valvular heart disease were different in each age group, the results after mechanical valve replacement were similar and satisfactory. Cerebral bleeding was a fatal complication in the elderly patients, so strict management with anticoagulant therapy was necessary throughout the follow-up period.