Coronary artery bypass grafting associated to aortic valve replacement in the elderly: survival and quality of life

Journal of Cardiothoracic Surgery

Gianantonio Nappi²  Maurizio Cotrufo¹  Raffaella Provenzano¹  Salvatore Giordano¹  Marisa De Feo²  Mariano Vicchio¹ 

[1]Department of Cardiovascular Surgery Pineta Grande Hospital Castel Volturno Caserta 81030 - Italy

[2]Department of Cardio Thoracic Surgery Second University of Naples Monaldi Hospital Naples 80100 - Italy

关键词: CABG;    quality of life;    elderly;    mechanical prostheses;    Heart valve replacement;   

Others  :  1153442
DOI  :  10.1186/1749-8090-7-13

 received in 2011-11-22, accepted in 2012-02-06,  发布年份 2012

【 摘 要 】

Myocardial ischemia is often associated to aortic valve stenosis in the elderly. Aim of this study was to evaluate the impact on survival and quality of life of CABG associated to aortic valve replacement in the septuagenarians and octogenarians.

Between January 1991 and January 2010, 520 patients ageing > 70 years underwent aortic valve replacement with a mechanical prosthesis in two Institutions. They were divided into 2 groups: Group A included 406 patients undergoing isolated aortic valve replacement; Group B 114 patients receiving aortic valve replacement and CABG. A comparative analysis of long-term survival and quality of life (SF-36 test) was performed.

Mean age was 74.2 ± 3.6 years (74.3 ± 3.6 in Group A, 74 ± 3.3 in Group B; p = 0.33). Hospital mortality was 9.5% (46 patients). Twenty-nine (7.8%) in Group A and 17 in Group B (15.2%)(p = 0.019). Actuarial survival was 88.5% ± 0.015 at 1 year, 81.9% ± 0.02 at 5 years, 76.6% ± 0.032 at 10 and 57.3 ± 0.1 at 15 years. Ten-year survival was 77% ± 0.034 in Group A and 77.8% ± 0.045 in Group B (p = 0.2). Multivariate analysis did not reveal associated CABG as a predictor of long term mortality. The scores obtained in the SF-36 test were similar in the two groups and significantly higher than those of the general population matched for country, age and sex (p < 0.001 in all domains).

Associated CABG determines a significant increase of hospital mortality in the elderly undergoing aortic valve replacement. Survivors did not show differences in long-term outcome and quality of life according to the presence of associated CABG.

【 授权许可】

   
2012 Vicchio et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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