Abstract

SEGALOTE, Rodrigo Coelho; POMERANTZEFF, Pablo Maria Alberto; BRANDAO, Carlos Manuel de Almeida  and  STOLF, Noedir Antônio Groppo. Aortic valve preservation surgery in elderly patients with aortic stenosis. Rev Bras Cir Cardiovasc [online]. 2008, vol.23, n.4, pp. 519-523. ISSN 0102-7638.  http://dx.doi.org/10.1590/S0102-76382008000400011.

OBJECTIVE: The aim of the present study was to investigate early and late results of the aortic valve preservation surgery (AVPS) through rough-hewing, demineralization and commissurotomy of the aortic valve (AV) in aortic stenosis (AS) at elderly people. METHODS: Thirty-two patients operated for pure AS, older than 65 years-old were studied at InCor FMUSP. Early and late results, clinical (ambulatory and phone interview) and echocardiographic follow-up were investigated. Actuarial and event-free survival analysis was done using the Kaplan-Meier method. RESULTS: Four patients (15.4%) had presented de novo AV stenosis. Five patients had progressed to moderate and two to serious aortic regurgitation. Demineralization, commissurotomy and rough-hewing were realized in 28, 20 and 16 patients, respectively. Nine patients had presented serious postoperative complications (28.1%). Two hospital-acquired pneumonia sepsis and five late deaths had occurred. Postoperative NYHA functional status were 70.5%, 17.6%, 5.8% and 5.8% for functional classes I, II, III and IV, respectively. Actuarial eight-year survival rate was 66.9 ± 12.1%. Eight-year free thromboembolism and endocarditis rate were 90.9 ± 8.7% and 100%, respectively. CONCLUSION: Aortic valve preservation surgery at the aged with AS was revealed a low morbidity and mortality procedure and presented an eight-year acceptable survival rate and functional status improvement among the studied series of patients.

Keywords : Aortic valve stenosis; Aortic valve [surgery]; Heart valve diseases [surgery]; Aged; Treatment outcome.