Swiss medical weekly
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Swiss medical weekly · May 1985
[Severe symptomatic valve defects in elderly patients. Spontaneous prognosis and surgical results].
Between 1970 and 1982 125 patients aged, 65 to 79 years with severe symptomatic valvular heart disease. Aortic valve disease (72 with aortic stenosis) was encountered in 76 cases, mitral valve disease (22 with mitral regurgitation) in 32 and combined aortic and mitral lesions in 17. Additional severe coronary artery disease (narrowing greater than 70%) was present in 25% of the patients. 80% of the patients were in NYHA class III and IV, and 42% had experienced an episode of congestive heart failure. 28 patients did not undergo surgery; 10 died before surgery and 18 were not accepted or refused the operation. ⋯ In the elderly patient with severe symptomatic valvular heart disease surgery can be performed with acceptable operative risk and good late results. Surgical treatment is particularly indicated in aortic stenosis, due to the poor spontaneous prognosis. Coronary artery disease is frequent in this age group but is not a contraindication for surgery, in view of the good postoperative results of additional aorto-coronary bypass grafting.