Long-Term Survival, Autonomy, and Quality of Life of Elderly Patients Undergoing Aortic Valve Replacement

Aims: We reviewed the long-term survival, autonomy, and quality of life (QoL) of elderly patients undergoing aortic valve replacement (AVR). Methods: Records of patients >= 75 years old that underwent AVR from 2002 to 2006 were retrospectively analyzed. Functional status was classified with Barthel Index (BI). QoL was presumed as the self-perception of well-being after AVR. Independent predictors of mortality were identified using the Cox proportional hazards model. Results: We included 114 patients, with a mean age of 78.5 +/- 2.5 years. Seventy (59.8%) patients were females. Mean additive and logistic EuroSCORE were 7 +/- 2 and 9 +/- 7, respectively. Follow-up on vital status was achieved for 113 (99.1%) patients after a mean period of 47.2 +/- 23.4 months. Twenty-seven (23.7%) patients died (including three operative deaths). Survival up to one, three, and five years of follow-up was 94.4%, 86.7%, and 76.1%, respectively. Multivariate analysis showed that pulmonary hypertension and diabetes were independent predictors of all-cause mortality. Information on BI score and QoL was obtained for 77 (89.5%) and patients. Among those, 69 (89.6%) were autonomous according to BI and 72 (93.5%) considered having had an improvement in QoL. Conclusion: Patients >= 75 years old undergoing AVR presented good medium-term survival. Predictors of an adverse outcome were significant pulmonary hypertension and diabetes. At follow-up, most achieved improvement of QoL and remained autonomous. These results stress that excellent long-term outcomes with AVR can be achieved in appropriately selected elderly patients. doi: 10.1111/j.1540-8191.2011.01360.x (J Card Surg 2012;27:20-23)