Reemplazo valvular aórtico con prótesis biológica en pacientes mayores de 70 años con estenosis aórtica

• RICARDO ZALAQUETT S ^[1] ; GABRIEL OLIVARES R ^[1] ; RICARDO MEJÍA M ^[1] ; FELIPE QUEZADA D ^[1] ; OSLANDO PADILLA P ^[1] ; PEDRO BECKER R ^[1] ; MANUEL IRARRÁZAVAL LL ^[1] ; SERGIO MORÁN V ^[1] ; CECILIA MUÑOZ C ^[1] ; RODRIGO GONZÁLEZ F ^[1]
  1. [1] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 139, Nº. 2, 2011, págs. 150-157
• Idioma: español
• Títulos paralelos:
  • Aortic valve replacement with bioprosthesis in patients 70 years old or older with aortic stenosis
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• Resumen

  • Background: Aortic valve stenosis is the most prevalent valvulopathy in the elderly, but it is frequently undertreated. Aim: To assess early and long term results of valve replacement with bioprostheses in patients 70 years old or older with aortic stenosis. Patients and Methods: A review of the database of the Cardiovascular Surgery Service of our hospital, for the period 1990-2007, identified 156 patients with aortic valve stenosis, aged 76.7 ± 4.5 years (67% males), that were subjected to an aortic valve replacement with bioprosthesis. Seventy eight (50%) were in functional class III-IV. Six patients had emergency surgery. In 67 patients (43%) coronary artery bypass graft were performed. Long term mortality was ascertained obtaining death records from Chilean death registry. Results: Operative mortality was 3.2% (5 patients). Four patients (2.6%) required a reoperation due to bleeding. The mean follow up was 66 ± 41 months. The survival rate at 1, 3 and 5years was 94%, 88% and 80%, respectively. Forty two patients (27%) were 80years old or older. In this sub-group, 1 patient (2.3%) died during the peri operative period and the estimated survival rate at 1, 3 and 5years was 97%, 92%, and 80%, respectively. Multivariate risk analysis, for the whole group, identified low ejection fraction and concomitant coronary artery bypass graft surgery as predictors of late mortality. Conclusions: Aortic valve replacement for aortic stenosis with bioprostheses in patients 70 years old or older had low perioperative mortality and morbidity and a good long term survival.