• Tiago R. Velho Cardiothoracic Surgery Department, Hospital de Santa Maria – CHLN, Lisboa, Portugal; Innate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, Oeiras, Portugal
  • Nuno Carvalho Guerra Cardiothoracic Surgery Department, Hospital de Santa Maria – CHLN, Lisboa, Portugal
  • Hugo Ferreira Cardiothoracic Surgery Department, Hospital de Santa Maria – CHLN, Lisboa, Portugal
  • Rafael Maniés Pereira Cardiothoracic Surgery Department, Hospital de Santa Maria – CHLN, Lisboa, Portugal
  • André Sena Cardiothoracic Surgery Department, Hospital de Santa Maria – CHLN, Lisboa, Portugal
  • Ricardo Ferreira Cardiothoracic Surgery Department, Hospital de Santa Maria – CHLN, Lisboa, Portugal
  • Ângelo Nobre Cardiothoracic Surgery Department, Hospital de Santa Maria – CHLN, Lisboa, Portugal



Introduction: Aortic valve stenosis (AS) is the most common valvular pathology in the elderly and surgery (AVR) remains the gold-standard. However, transcatheter aortic valve replacement (TAVI) has become an emerging alternative to surgery. In a recent survey from the European Society of Cardiology, 9,4% stated that age was the main reason to propose for TAVI.

Methods: Single-center retrospective study including 353 patients (149 ≥80 years-old;204 with 60-69 years-old) submitted to AVR between 2013-2016. Primary endpoint was survival. Secondary outcomes included the rate of post- -operative complications. Long-term survival was determined by Kaplan-Meier survival analysis. Continuous variables were analyzed with t-test and linear regression and categorical variables with chi-square or Fisher.

Results: clinical characteristics were similar between the two groups. Both had similar survival at 30 days, 12 (93,29% 60-69yo vs 91,47% ≥80yo) and 24 months (88,34% 60-69yo vs 86,11% ≥80yo). However, rapid deployment valves (RD) had better survival rates in elderly patients. Cross-clamp time was lower in ≥80yo group, with higher percentage of RD valves (20,1% vs 4.9% in 60-69yo). The rate of post-operative atrial fibrillation was higher in >80yo group (29,06% vs. 17,28%,p=0,0147). In all patients, cross-clamp time was directly related to ventilation time(p=0,025) and chest drainage(p=0,0015).

Conclusion: AVR after 80yo is safe. Cross-clamp time is directly correlated with ventilation time and bleeding, with a stronger correlation in patients over 80yo. RD valves reduce cross-clamp times, so their use in elderly may improve surgery outcome. Prospective studies are needed to evaluate if age may be clinical criteria for a RD.


Download data is not yet available.


B. Iung and A. Vahanian, “Epidemiology of acquired valvular heart disease,” Can. J. Cardiol., 2014.

G. W. Eveborn, H. Schirmer, G. Heggelund, and P. Lunde, “The evolving epidemiology of valvular aortic stenosis . The Tromsø

Study,” pp. 396–400, 2013.

D. Mozaffarian, E. J. Benjamin, A. S. Go, D. K. Arnett, M. J. Blaha, M. Cushman, S. R. Das, S. de Ferranti, J.-P. Després, H. J. Fullerton, V. J. Howard, M. D. Huffman, C. R. Isasi, M. C. Jiménez, S. E. Judd, B. M. Kissela, J. H. Lichtman, L. D. Lisabeth, S. Liu, R. H. Mackey, D. J. Magid, D. K. McGuire, E. R. Mohler, C. S. Moy, P. Muntner, M. E. Mussolino, K. Nasir, R. W. Neumar, G. Nichol, L. Palaniappan, D. K. Pandey, M. J. Reeves, C. J. Rodriguez, W. Rosamond, P. D. Sorlie, J. Stein, A. Towfighi, T. N. Turan, S. S. Virani, D. Woo, R. W. Yeh, and M. B. Turner, Heart Disease and Stroke Statistics-2016 Update, vol. 133, no. 4. 2016.

F. Nicolini, A. Agostinelli, A. Vezzani, T. Manca, F. Benassi, A. Molardi, and T. Gherli, “The evolution of cardiovascular surgery

in elderly patient: A review of current options and outcomes,” Biomed Res. Int., vol. 2014, 2014.

B. Iung, G. Baron, E. G. Butchart, F. Delahaye, C. Gohlke-Bärwolf, O. W. Levang, P. Tornos, J. L. Vanoverschelde, F. Vermeer, E. Boersma, P. Ravaud, and A. Vahanian, “A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on valvular heart disease,” Eur. Heart J., vol. 24, no. 13, pp. 1231–1243, 2003.

E. Ho, M. N. Mathur, P. W. Brady, D. Marshman, R. J. Brereton, D. E. Ross, R. Bhindi, and P. S. Hansen, “Surgical aortic valve replacement in very elderly patients aged 80 years and over: Evaluation of early clinical outcomes,” Hear. Lung Circ., vol. 23, no. 3, pp. 242–248, 2014.

V. Falk, H. Baumgartner, J. J. Bax, M. De Bonis, C. Hamm, P. J. Holm, B. Iung, P. Lancellotti, E. Lansac, D. R. Muñoz, R. Rosenhek,

J. Sjögren, P. Tornos Mas, A. Vahanian, T. Walther, O. Wendler, S. Windecker, and J. L. Zamorano, 2017 ESC/EACTS Guidelines for the management of valvular heart disease, vol. 52, no. 4. 2017.

G. Practitioners, “TAVI SURVEY Performed by the ESC Council for Cardiology Practice.”

P. J. Tully, P. Roshan, G. D. Rice, A. Sinhal, J. S. Bennetts, and R. A. Baker, “Change in quality of life after transcatheter aortic valve implantation and aortic valve replacement surgery in Australian patients aged ≥ 75 years: The effects of EuroSCORE and patient operability,” J. Geriatr. Cardiol., vol. 12, no. 1, pp. 30–36, 2015.

G. Esses, E. Andreopoulos, H. M. Lin, S. Arya, and S. Deiner, “A Comparison of Three Frailty Indices in Predicting Morbidity and Mortality after On-Pump Aortic Valve Replacement,” Anesth. Analg., vol. 126, no. 1, pp. 39-45, 2018.

T. Cahill, M. Chen, K. Hatashida, A. Latib, T. Modine, N. Piazza, S. Redwood, L. Sondergaard, and B. Prendergast, “Transcatheter aortic valve implantation-current status and future perspectives,” Eur. Heart J., vol. 39, no. 28, pp. 2625–2634,

A. Khosravi and O. Wendler, “TAVI 2018: from guidelines to practice,” E-Journal Cardiol. Pract., vol. 15, no. 29, 2018.

M. Poullis, M. Pullan, J. Chalmers, and N. Mediratta, “The validity of the original EuroSCORE and EuroSCORE II in patients over the age of seventy,” Interact. Cardiovasc. Thorac. Surg., vol. 20, no. 2, pp. 172–177, 2015.

S. Leontyev, T. Walther, M. A. Borger, S. Lehmann, A. K. Funkat, A. Rastan, J. Kempfert, V. Falk, and F. W. Mohr, “Aortic Valve Replacement in Octogenarians: Utility of Risk Stratification With EuroSCORE,” Ann. Thorac. Surg., vol. 87, no. 5, pp. 1440-1445, 2009.

N. Al-Sarraf, L. Thalib, A. Hughes, M. Houlihan, M. Tolan, V. Young, and E. McGovern, “Cross-clamp time is an independent predictor of mortality and morbidity in low- and high-risk cardiac patients,” Int. J. Surg., vol. 9, no. 1, pp. 104–109, 2011.




How to Cite

Velho TR, Carvalho Guerra N, Ferreira H, Maniés Pereira R, Sena A, Ferreira R, Nobre Ângelo. AGE IS NOT JUST A NUMBER FOR A RAPID DEPLOYMENT VALVE IN OCTOGENARIANS. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Apr. 17 [cited 2024 May 22];27(3):191-7. Available from:



Original Articles

Most read articles by the same author(s)

1 2 3 > >>