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Right Thoracotomy Surgical Aortic Valve Replacement in High Risk Octogenarians
Mark Anderson, Neil Stockmaster, George Batsides, Anthony Lemaire.
UMDNJ / RWJUH, New Brunswick, NJ, USA.
OBJECTIVE: To review our results with right thoracotomy surgical aortic valve (RTAVR) replacement in octogenarians.
METHODS: All patients age 80 years or greater who underwent a RTAVR were retrospectively reviewed. The charts were examined for preoperative characterictics, operative variables and postoperative outcomes.
RESULTS: A total of 128 patients were identified. Mean age was 83.4. 67% were male. 89% had primary aortic stenosis. Mean preoperative STS risk was 11.9. All patients underwent primary valve replacement with a bioprosthesis. Mean crossclamp time was 68.2 mins and bypass time 93.1 mins. There were no conversions to sternotomy. Mean time to extubation was 4.4 hours. CT drainage 220ml / 1st 24 hours. Mean LOS in ICU was 18 hours and hospital 5.1 days. The incidence of permanent neurologic deficit was 1.5%. A permanent pacemaker was required in 2.3%. 30 day mortality was 1.5%.
CONCLUSIONS: Surgical aortic valve replacement can be safely performed in octogenarians with an elevated risk profile. These outcomes need to be carefully considered when evaluating alternative techniques such as catheter aortic valve replacement.
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