From: Reuters
Published February 25, 2008 03:49 PM

Oldest patients fare well after heart valve surgery

By Anne Harding

NEW YORK (Reuters Health) - Age shouldn't be a disqualifying factor for patients who need surgery to replace a major valve in the heart, according to new data.

Dr. Farzan Filsoufi and colleagues from the Mount Sinai School of Medicine in New York City found that people 80 years of age or older who underwent aortic valve replacement fared nearly as well as younger patients.

Filsoufi said in an interview with Reuters Health that their findings show the procedure shouldn't be delayed in older people who are good candidates for surgery. "There's a tendency...to delay valvular surgery in elderly patients because they are considered high risk."

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Blockage of the aortic valve can occur with aging and is expected to become more common as the U.S. population ages, Filsoufi's group notes in their report, published in the Journal of the American Geriatrics Society. To obtain updated information on the outcome of valve replacement surgery according to age, the researchers reviewed the records of 1,308 consecutive patients who underwent the procedure at Mount Sinai between 1998 and 2006. Of these patients, 17.6 percent were 80 or older.

The older patients were no more likely to die in the hospital than the younger patients, the researchers found.

However, they did have a greater risk of respiratory failure, and spent an average of 10 days in the hospital after the procedure, compared with 7 days for the younger patients.

About two thirds of the oldest patients lived for at least 5 years after the operation, a rate of survival comparable to people of the same age in the general population.

"Over the last decade the results of cardiac surgery have improved," Filsoufi said. "This improvement not only has been seen in the younger patients, it also has been seen in elderly patients."

Surgeons are investigating a less invasive version of the surgery known as percutaneous valve replacement, which remains in the experimental stages, the researcher noted.

Some have argued for testing the procedure in older people, he added, based on the assumption that these patients don't have long to live so it won't matter as much if the repair doesn't last.

But given the current findings, Filsoufi said, the oldest patients should be given the option of having the "more standard and durable procedure," as they may live for several years after undergoing the surgery.

SOURCE: Journal of the American Geriatrics Society, February 2008.

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