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Asian Cardiovasc Thorac Ann · Oct 2014
Aortic valve reconstruction using autologous pericardium for ages over 80 years.
- Shigeyuki Ozaki, Isamu Kawase, Hiromasa Yamashita, Shin Uchida, Yukinari Nozawa, Mikio Takatoh, So Hagiwara, and Nagaki Kiyohara.
- Department of Cardiovascular Surgery, Toho University Ohashi Medical Center, Tokyo, Japan ozakis@oha.toho-u.ac.jp.
- Asian Cardiovasc Thorac Ann. 2014 Oct 1;22(8):903-8.
BackgroundWe performed original aortic valve reconstruction using autologous pericardium; the feasibility for elderly patients is reviewed.MethodsFrom April 2007 through September 2011, aortic valve reconstruction was carried out in 86 patients over the age of 80 years. Twenty-seven patients were male and 59 were female. Mean age was 82.9 ± 2.5 years. Seventy-two patients had aortic stenosis and 14 had aortic regurgitation. Mean preoperative surgical annular diameter was 19.5 ± 2.5 mm. There were 80 (90.7%) cases of small aortic annulus. Mean preoperative logistic EuroSCORE was 22.9 ± 15.8.ResultsIsolated aortic valve reconstructions were performed in 51 patients. Concomitant procedures included coronary artery bypass grafting in 6, hemiarch aortic replacements in 6, 9 maze procedures, and some combinations. No conversion to valve replacement was required. Mean follow-up was 1243 days. There were 3 hospital deaths due to noncardiac causes. No reoperation was needed. Survival at 56 months was 87.0%. No thromboembolic event occurred. Echocardiography 3.5 years after surgery revealed an average peak pressure gradient of 14.6 ± 3.8 mm Hg. No moderate or severe regurgitation was recorded.ConclusionsAortic valve reconstruction is feasible for patients older than 80 years, resulting in good hemodynamics and a better quality of life, without anticoagulation.© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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