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Eur J Cardiothorac Surg 2005;27:276-280
© 2005 Elsevier Science NL

Valvular surgery in octogenarians: operative risks factors, evaluation of Euroscore and long term results

Service de Chirurgie cardiaque, Hopital de la Timone, 246 rue St Pierre, 13385 Marseille cx 05, France

Received 16 July 2004; received in revised form 13 October 2004; accepted 25 October 2004.

^* Corresponding author. Tel.: +33 4 91 38 57 17; fax: +33 4 91 85 41 40. (E-mail: fcollart{at}univ-aix.fr).

Objectives: In the last decade, cardiac surgery in octogenarians is becoming a routinely performed procedure in our Western countries. The functional benefit of this surgery had already been proved. The aim of this study was to evaluate operative mortality, to identify pre- and post-operative risk factors of early and late mortality, to assess the Euroscore count in this high-risk group of patient and to evaluate late results of this surgery. Methods: We reviewed 215 consecutive patients with a mean age of 83±2 years having undergone valvular surgery. There were 127 female patients (57.1%) and 88 males (42.9%). One hundred and fifty-nine patients (74%) underwent aortic valve replacement 42 (19.5%) mitral surgery and 14 (6.5%) double valve surgery. There were 32 (14.9%) re-operative cases. Twenty-seven patients (12.6%) were operated on in emergency. There were 32 re-operations (14%). The EuroSCORE was used to assess predicted operative risk. Mean Euroscore additive count was 9.5±2.3 and mean logistic Euroscore was 15.1%. Results: Operative mortality was 8.8% (19 patients). Left ventricular dysfunction was the only pre-operative significant risk factors of mortality (P=0.05). Low cardiac output (P<0.001), gastrointestinal complications (P=0.03) and surgical reexploration (P=0.001) were significant risk factors of mortality. Mean survival was 84% after one year and 56% after 5 years. Conclusions: Valvular surgery in octogenarians is a safe and low risk procedure compared to functional benefit and long-term survival. Our data how that logistic Euroscore overestimates the mortality in this high-risk group of patients.

Key Words: Valvular surgery • Octogenarian • Euroscore

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