Early and Late Results of Valvular Surgery in the Elderly : PANEL DISCUSSION ON PROBLEMS IN THE TREATMENT OF CARDIOVASCULAR DISEASES IN THE ELDERLY : 51th Annual Scientific Session of the Japanese Circulation Society
スポンサーリンク
概要
- 論文の詳細を見る
From January, 1979 to June, 1986, 70 consecutive elderly patients (30 males and 40 females) age 65 years or older underwent open heart surgery for valvular heart diseases at Mitsui Memorial Hospital in Tokyo. Seventeen patients (24.3%) were septuagenarians. Porcine bioprosthesis (Carpentier-Edwards) was inserted for the mitral and the tricuspid position, and mechanical valve (Bjork-Shiley or Duromedics) for the aortic position. Every patients received an antiocoagulant (warfarin) postoperatively all through the follow-up period. The mean duration of follow-up was 43 months and the cumulative follow-up was 195 patient-years. Fifteen patients died in hospital after operation, giving an operative mortality rate of 21.4%. Cardiac death occurred in only 5 and the other 10 patients died of other causes such as sepsis, cerebrovascular accident, and agranulocytosis, showing that these patients were already in an advanced stage of cardiac failure. Late death occurred in 5 patients, but there was no clear-cut cardiac death documented. The actuarial survival rated at 3 years old 5 years were 71.6% and 65.9% for all patients, and 90.5% and 83.3% for early survivors. The functional and symptomatic improvement of 49 late survivors was remarkable. Thirty-eight patients (77.6%) are now NYHA class I and II. The incidence of thromboembolic and hemorrhagic episodes was fairly low - 2% and 3% per patient year, respectively. Although the operative mortality is rather high in this study, it is clear that the surgical management of elderly patients with life-threatening valvular lesions results in substantial improvement and good prognosis in surviving patients. Advanced age alone should not be a contraindication to valvular surgery, and surgical treatment should be indicated in the earlier stages of cardiac failure.
- 社団法人日本循環器学会の論文
- 1988-05-20
著者
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Sakakibara Yuzuru
Department Of Cardiovascular Surgery Graduate School Of Comprehensive Human Science University Of Ts
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Wanibuchi Yasuhiko
Department Of Cardiovascular Surgery Mitsui Memorial Hospital
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Wanibuchi Yasuhiko
Center For Cardiovascular Disease Mitsui Memorial Hospital
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Wanibuchi Yasuhiko
Cardiovascular Surgery Mitsui Memorial Hospital
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Furuta Shouichi
Divisions Of Cardiology Mitsui Memorial Hospital
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INO Takashi
Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University
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Ino Takashi
Department Of Cardiovascular Surgery Mitsui Memorial Hospital
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Furuta Shoichi
Center For Cardiovasc. Dis. Mitsui Memorial Hosp.
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Furuta Shoichi
Department Of Surgery Tokyo University School Of Medicine
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Fukuda Sachito
Divisions Of Cardiology Mitsui Memorial Hospital
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Fukuda Sachito
Department Of Cardiovascular Surgery Mitsui Memorial Hospital
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Sakakibara Yuzuru
Department Of Surgery Mitsui Memorial Hospital
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SHIIHARA HIDESHIGE
Department of Surgery, Mitsui Memorial Hospital
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Furuta Shoichi
Center For Cardiovascular Disease Mitsui Memorial Hospital
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Shiihara Hideshige
Department Of Surgery Mitsui Memorial Hospital
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Furuta Shoichi
Department Of Cardiovascular Surgery Mitsui Memorial Hospital
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Wanibuchi Yasuhiko
Department Of Cardiovascular Surgery In Mitsui Memorial Hospital
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Furuta Shoichi
Center For Cardiovascular Disease Mitsui Memorial Hospital.
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Furuta Shoichi
Department Of Cardiovascular Surgery In Mitsui Memorial Hospital
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