Back to 2015 Annual Meeting Display Posters

OBJECTIVE: To evaluate the perioperative results of an aortic valve replacement (AVR) by right anterior mini-thoracotomy (RAMT) in patients over 80 years old
METHODS: From June 2010 to November 2014, 34 patients over the age of 80 underwent a OVR by RAMT, 21 received a stented biological valve 12 received a "suturless" valve, and one received a "stentless" one.
RESULTS: The average age was 83 ± 1.8 years, the logistic EuroSCORE was 10.6 ± 6.03 and Euroscore2 2.2 ± 1.77. LVEF was 64 ± 9.3%, aortic surface of 0.6 ± 0.12 cm², the average gradient was 49.4 ± 15.43 mmHg. Thirty patients underwent an isolated AVR, 2 an enlargement of the aortotomy was made, one was associated to a replacement of the ascending aorta and 1 a septal myomectomy. The aortic cross clamp time and CPB was respectively 86 ± 23, min (52-134 min) and 116 ± 32 min (79-181 min). The aortic cross clamp time for standard valves was 91 ± 21 and 70 min ± 19 min for suturless valves (p = 0.006) and the CPB time of respectively 122 ± 31 min and 99 ± 27 min (p = 0.02) . Intraoperative conversion to sternotomy was required in one patient due to bleeding on the enlargement aortoplasty and a sternotomy was required postoperatively for a bleeding from the mammary artery. Two patients in suturless group had a para-valvular regurgitation in immediate postoperative and required revision at D1 by sternotomy for one patient and by the same way at D3 for the second . One patient died at J1 of right ventricular failure.
The median ICU stay was 2 days and in hospital stay was 8 days. One third of patients were able to return home after an average of nine days of hospitalization.
CONCLUSIONS: The AVR by RAMT can be offered to patients over 80 years old mainly using suturless valves to decrease significantly the time of aortic clamping and CPB.