Valve Replacement Is Often Low Risk for Older Patients

By Sondra Forsyth

Patients who are 90 years or older and have a narrowed heart valve can safely be given a valve replacement, according to new research. The operation to do this, known as aortic valve replacement (AVR), has only a low risk of death, or a stroke during the procedure.

In the study, four out of five patients were alive one year after AVR.

The findings, by researchers from the Mayo Clinic, in Rochester, Minn., were published in The Annals of Thoracic Surgery.

The investigators looked at the records of 59 patients who were at least 90 years old and who had undergone AVR for severe aortic stenosis – the narrowing of the aortic valve, which leads to restricted blood flow from the heart.

Among the study subjects, surgical AVR (SAVR) was used in 33 (56%) of patients, and transcatheter AVR (TAVR), a minimally invasive treatment, was used in 26 (44%). Two patients died following SAVR, and one died following TAVR. The survival rate showed no significant difference between the two groups.

After the procedure, five patients (21.7%) in the SAVR group were discharged home compared with 12 patients (48%) who had undergone TAVR. The rest of the patients were discharged to a skilled nursing home facility.

“We hope that, through our results, providers will understand that aortic valve replacement should not be denied in select symptomatic…patients with severe aortic valve stenosis,” said Kevin L. Greason, MD. “Nearly 80% of our patients had significant heart failure symptoms prior to surgery and most experienced marked improvement following the operation.”