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European Heart Journal 1995 16(4):529-533;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Bioprosthetic valve replacement in the elderly

G. HELFT, X. TABONE, J. L. GEORGES, E. LOMAMA*, H. NEMATALLA, J. P. METZGER, A. HEULIN and A. VACHERON

Clinique Cardiologique de l'Hôpital Necker Paris, France
*Centre Medical des Pins, Lamotte-Beuvron France

revised 29 September 1994; accepted 20 October 1994.

Dr G. Helft, Clinique Cardiologique de I'Hòpital Necker, 149 rue de Sèvres 75749 Paris, France.

Abstract

One hundred and ten patients aged more than 65 years (mean, 73.4; range, 65–82) underwent successful bioprosthetic valve replacement (aortic, n = 71; mitral, n=32; both, n = 7) from 1979 to 1985. The valve was pericardial in 39 cases and porcine in 78. The mean follow-up was 75 months (total, 688 patient-years; range, 2 months to 12 years). Actuarial patient survival was 79.4% at 5 years and 55.2% at 10 years. Thirty-seven patients died: 18 from valve-related causes and 19 from other causes. Eight patients have been reoperated on for valve-related complications (1.17% per patient-year): five primary deteriorations, two paravalvular leaks and one case of endocarditis. One surgical death occurred (12.5%). Twenty-five percent of the patients were receiving anticoagulants because of atrial fibrillation, and 5.4% developed severe bleeding (3.8% patient-year).

Mid-term follow-up of these patients aged more than 65 years and undergoing bioprosthetic valve replacement surgery revealed a low rate of documented primary structural deterioration (0.9% per patient-year), a low mortality rate on reoperation (12.5%) and a high mortality rate due to non valve-related causes (51.4%).

Key Words: Bioprostheses • elderly patients


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