Seksen Yaş Üstü Hastalarda Mekanik Aort Kapak Replasmanı

Key Findings & Data:Material and Method: A retrospectivereview was performed on 23 octogenarian patients who underwentmechanical aortic valve replacement.

💡

Conclusion & Impact:Nocomplications were observed in 56.52% patients during their hospital stay.The overall hospital mortality was 8.7%.

🔬Design:Review & Systematic Survey

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Aim: This study analyzes the long-term outcomes of mechanical aortic valvereplacement in octogenarian patients. Material and Method: A retrospectivereview was performed on 23 octogenarian patients who underwentmechanical aortic valve replacement. Hospital mortality, postoperativeintensive care unit stay, hospital stay and long-term results was examined.Estimates of the cumulative event mortality rate were calculated by theKaplan-Meier method. Results: The mean age of all patients was 82.9±2.3years and most were men (65.22%). The median ejection fraction was45%. 73.91% of patients were in New York Heart Association class III-IV.Thirteen patients (56.52%) in this study underwent combined procedure, theremaining 10 (43.48%) patients underwent isolated aortic valve replacement.The most common valve size was 23 mm. The mean intensive care unitstay was 1.76±1.14 days. The mean hospital stay was 9.33±5.06 days. Nocomplications were observed in 56.52% patients during their hospital stay.The overall hospital mortality was 8.7%. Follow-up was completed for all 23patients. Median follow-up time was 33 months (1-108 months). Actuarialsurvival among discharged from hospital was 59% at 5 years. Discussion:Mechanical aortic valve replacement is a safe procedure in octogenarianpatients and can be performed safely even in combined procedure.

Özet

Amaç: Bu çalışmada seksen yaş üstü hastalarda mekanik aort kapak replasmanının uzun dönem sonuçları analiz edilmiştir. Gereç ve Yöntem: 23 seksen yaş üstü mekanik aort kapak replasmanı yapılan hasta retrospektif olarak tarandı. Hastane mortalitesi, postoperatif yoğun bakımda kalış, hastanede kalış ve uzun dönem sonuçları değerlendirildi. Kümülatif olay ölüm oranıtahminleri Kaplan-Meier metodu ile hesaplanmıştır. Bulgular: Hastaların ortalama yaşları 82.9±2.3 yıldı ve çoğunluk erkekti (65.22%). Ortalama ejeksiyon fraksiyonu %45ti. Hastaların %73.91i New York Heart Association Sınıf III-IVtü. Bu çalışmada 13 hastaya (%56.52) kombine prosedür, geri kalan10 hastaya (%43.48) izole aort kapak replasmanı uygulandı. En sık kapak ölçüsü 23mmydi. Ortalama yoğun bakımda kalış süresi 1.76±1.14 gündü. Ortalama hastanede kalış süresi 9.33±5.06 gündü. Hastaların %56.52sında hastanede kalış süresince herhangi bir komplikasyon gözlenmedi. Toplam hastane mortalitesi %8.7ydi. 23 hastanın tamamında takip tamamlandı. Ortalamatakip süresi 33 aydı (1-108 ay). Hastaneden taburcu olanlarda sağ kalım 5yılda %59du. Tartışma: Mekanik aort kapak replasmanı seksen yaş üstü hastalarda güvenli bir prosedürdür ve kombine prosedürle bile güvenle yapılabilir.

🔖

Cite This Article

YALÇINKAYA, A., TAŞOĞLU, İ., DEMİR, A., LAFÇI, G., ÇOLAK, N., KUBAT, E., YILMAZ, M., KERVAN, Ü. (2022). Seksen Yaş Üstü Hastalarda Mekanik Aort Kapak Replasmanı. Journal of Clinical and Analytical Medicine, Cilt: 5 - Sayı: 3, 224–228. https://ajindex.com/articles/561136

📄 Full Text PDF Viewer

Open in New Tab ↗

↗New Tab

📄

PDF görüntüleyici hazırlanıyor...

References (10)

Thourani VH, Ailawadi G, Szeto WY, Dewey TM, Guyton RA, Mack MJ, et al. Outcomes of surgical aortic valve replacement in high-risk patients: a multiinsti- tutional study. Ann Thorac Surg 2011;91:49-55
Vicchio M, Della Corte A, De Santo LS, De Feo M, Caianiello G, Scardone M, et al. Tissue versus mechanical prostheses: quality of life in octogenarians. Ann Thorac Surg 2008;85:1290-5
Rizzoli G, Bejko J, Bottio T, Tarzia V, Gerosa G. Valve surgery in octogenarians: does it prolong life? Eur J Cardiothorac Surg 2010;37:1047-55
Ruel M, Chan V, Bédard P, Kulik A, Ressler L, Lam BK, et al. Very long-term survival implications of heart valve replacement with tissue versus mechanical prostheses in adults _____60 years of age. Circulation 2007;116:1294-300
Fihn SD, Callahan CM, Martin DC, McDonell MB, Henikoff JG, White RH. The risk for and severity of bleeding complications in elderly patients treated with warfarin. Ann Intern Med 1996;124:970-9
Hirsh J, Dalen JE, Deykin D, Poller L. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest 1992;102:312-26
Thourani VH, Myung R, Kilgo P, Thompson K, Puskas JD, Lattouf OM, et al. Longterm outcomes after isolated aortic valve replacement in octogenarians: a modern prospective. Ann Thorac Surg 2008;86, 1458 65
D.S. Fruitman, C.E. MacDougall, D.B. Ross. Cardiac surgery in octogenarians: can elderly patients benefit? Ann Thorac Surg 1999;68:212935
Melby SJ, Zierer A, Kaiser SP, Guthrie TJ, Keune JD, Schuessler RB, et al. Aortic valve replacement in octogenarians: risk factors for early and late mortality. Ann Thorac Surg 2007;83: 16516
Barnett SD, Halpin LS, Speir AM, Albus RA, Akl BF, Massimiano PS, et al. Post- operative complications among octogenarians after cardiovascular surgery. Ann Thorac Surg 2003;76:72631. 11.Akins CW, Daggett WM, Vlahakes GJ, Hilgenberg AD, Torchiana DF, Madsen JC, et al. Cardiac operations in patients 80 years old and older. Ann Thorac Surg 1997;64:60614. 12.Arbatli H, Unal M, Demirsoy E, Tansal S, Yağan N, Tükenmez F, et al.Coronary bypass surgery in octogenarians.Anadolu Kardiyol Derg. 2001;1(3):156-63. 13.Kara I, Ay Y, Köksal C, Aydın C, Yanartaş M, Yıldırım T. The quality of life after cardiac surgery in octogenarians and evaluation of its early and mid-term results. Anadolu Kardiyol Derg. 2012;12:352-8. 14.Thulin LI, Sjogren JL. Mechanical versus biological aortic valve implants in the elderly. A c