科研之友
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摘要
Background: Aortic valve stenosis is the most prevalent valvulopathy in the elderly, but it is frequently undertreated. Aim: To assess early and long term results of valve replacement with bioprostheses in patients 70 years old or older with aortic stenosis. Patients and Methods: A review of the database of the Cardiovascular Surgery Service of our hospital, for the period 1990-2007, identified 156 patients with aortic valve stenosis, aged 76.7 +/- 4.5 years (67% males), that were subjected to an aortic valve replacement with bioprosthesis. Seventy eight (50%) were in functional class III-IV Six patients had emergency surgery. In 67 patients (43%) coronary artery bypass graft were performed. Long term mortality was ascertained obtaining death records from Chilean death registry Results: Operative mortality was 3.2% (5 patients). Four patients (2.6%) required a reoperation due to bleeding. The mean follow up was 66 +/- 41 months. The survival rate at 1, 3 and 5 years was 94%, 88% and 80%, respectively Forty two patients (27%) were 80 years old or older. In this sub-group, 1 patient (2.3%) died during the peri operative period and the estimated survival rate at 1, 3 and 5 years was 97%, 92%, and 80%, respectively Multivariate risk analysis, for the whole group, identified low ejection fraction and concomitant coronary artery bypass graft surgery as predictors of late mortality. Conclusions: Aortic valve replacement for aortic stenosis with bioprostheses in patients 70 years old or older had low perioperative mortality and morbidity and a good long term survival. (Rev Med Chile 2011; 139: 150-157).
- 出版日期2011-2
