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Current outcomes after isolated Aortic Valve Replacement in the Octogenarians.

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Objective: To assess the actual hospital morbi-mortality of isolated aortic valve replacement (AVR) in a monocentric cohort of octogenarians between 2002 and 2014.

Methods: Between 2002 and 2014, 769 octogenarians patients, male in 46,4% (n=357) with a mean age of 82.7±2.4 [80 - 94.4] underwent isolated AVR with implantation of a biological valvular prosthesis in our center. Main surgical indication was aortic stenosis in 79.3% of patients. Redo surgeries were excluded.

Results: Hospital mortality was 1.95% (n=15) with an Euroscore 2 average of 2,7± 3 [0,9 – 41,2]. Mean Intensive Care Unit stay was 3,1 ±4,5 days for a total hospital stay of 13,5±7,9 days. Main postoperative complications included blood transfusion (62,5%),  renal failure (15,6%) requiring dialysis in 2,7 % of the cases, para-prosthesis aortic insufficiency (1 to 2/4) (3.4%), prolonged artificial ventilation (>48h) (2.9%), pace-maker implantation (1,4%), stroke (1.2 %) and mediastinistis (0,5%). Multivariate predictors for hospital mortality were cardiogenic shock (OR = 34.8 [4.2-215.9]) and BMI greater than 30 (OR 4.5 [1.3-16.2]).

 Conclusion: Nowadays, aortic valve replacement in octogenarians is a reliable surgery, with a low hospital morbi-mortality rate and a better identification of patients at risk.

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