Publication:

Postoperative clinical outcome of aortic valve surgery in elderly patients and the effect of advanced age on atrial fibrillation: a comparative retrospective study

Background This study was conducted to evaluate the clinical outcomes of aortic valve surgery in elderly patients and to determine the factors associated with atrial fibrillation.

Methods Between 2011 and 2015, 54 patients who underwent isolated aortic valve replacement for aortic stenosis without preoperative arrhythmia were divided into two groups as 50-69 years old (group I; n=25) and 70 years and older (group II; n=29). Patient's medical record was retrospectively reviewed. Pre, peri and post operation data was compared. The deaths that occurred in the first 30 days were evaluated as mortality and complications as morbidity.

Results Mortality rate was found 9.2% (5/54) (p=0.358) in the first 30 days and 8.1% (4/49) the first six months follow-up and no difference was found between the two groups (p=0.153).  The following parameters were observed in group 2 and were found statistically significant: average age (p<0.01), euroscore (p<0.01), duration of cardiopulmonary bypass (p<0.01), duration of mechanical ventilation (p<0.01), duration of stay in intensive care unit (p<0.01), duration of stay hospital (p=0.01), acute renal failure (p=0.03), the need for dialysis (p<0.01), atrial fibrillation (p=0.04), pneumonia (p=0.03) and pleural fluid (p=0.01). We found that new-onset atrial fibrillation associated with advanced age (p=0.02), hypertension (p=0.04), duration of cardiopulmonary bypass (p=0.03), duration of aortic cross-clamp (p<0.01), postoperative anaemia (p=0.04), high creatinine values (p<0.01) and cerebrovascular events (p<0.01).

Conclusions Mortality rate was found 9.2% (5/54) (p=0.358) in the first 30 days and 8.1% (4/49) the first six months follow-up and no difference was found between the two groups (p=0.153).  The following parameters were observed in group 2 and were found statistically significant: average age (p<0.01), euroscore (p<0.01), duration of cardiopulmonary bypass (p<0.01), duration of mechanical ventilation (p<0.01), duration of stay in intensive care unit (p<0.01), duration of stay hospital (p=0.01), acute renal failure (p=0.03), the need for dialysis (p<0.01), atrial fibrillation (p=0.04), pneumonia (p=0.03) and pleural fluid (p=0.01). We found that new-onset atrial fibrillation associated with advanced age (p=0.02), hypertension (p=0.04), duration of cardiopulmonary bypass (p=0.03), duration of aortic cross-clamp (p<0.01), postoperative anaemia (p=0.04), high creatinine values (p<0.01) and cerebrovascular events (p<0.01).