The evolution of cardiovascular surgery in elderly patient: a review of current options and outcomes

Francesco Nicolini, Andrea Agostinelli, Antonella Vezzani, Tullio Manca, Filippo Benassi, Alberto Molardi, Tiziano Gherli, Francesco Nicolini, Andrea Agostinelli, Antonella Vezzani, Tullio Manca, Filippo Benassi, Alberto Molardi, Tiziano Gherli

Abstract

Due to the increase in average life expectancy and the higher incidence of cardiovascular disease with advancing age, more elderly patients present for cardiac surgery nowadays. Advances in pre- and postoperative care have led to the possibility that an increasing number of elderly patients can be operated on safely and with a satisfactory outcome. Currently, coronary artery bypass surgery, aortic and mitral valve surgery, and major surgery of the aorta are performed in elderly patients. The data available show that most cardiac surgical procedures can be performed in elderly patients with a satisfactory outcome. Nevertheless, the risk for these patients is only acceptable in the absence of comorbidities. In particular, renal dysfunction, cerebrovascular disease, and poor clinical state are associated with a worse outcome in elderly patients. Careful patient selection, flawless surgery, meticulous hemostasis, perfect anesthesia, and adequate myocardial protection are basic requirements for the success of cardiac surgery in elderly patients. The care of elderly cardiac surgical patients can be improved only through the strict collaboration of geriatricians, anesthesiologists, cardiologists, and cardiac surgeons, in order to obtain a tailored treatment for each individual patient.

References

    1. Hannan EL, Kilburn H, Jr., Racz M, Shields E, Chassin MR. Improving the outcomes of coronary artery bypass surgery in New York State. Journal of the American Medical Association. 1994;271(10):761–766.
    1. Ghali WA, Ash AS, Hall RE, Moskowitz MA. Statewide quality improvement initiatives and mortality after cardiac surgery. Journal of the American Medical Association. 1997;277(5):379–382.
    1. Spencer G. Projections of the Population of the United States, By Age, Sex and Race: 1988–2080. Current Population Reports, Population Estimates and ProjectionsGovernment Printing Office. Washington, DC, USA: 1989.
    1. National Center for Health Statistics. Vital Statistics of the United States US Government Printing Office. Vol. 2. Washington, DC, USA: 1992.
    1. Friedrich I, Simm A, Kötting J, Thölen F, Fischer B, Silber RE. Cardiac surgery in the elderly patient. Deutsches Ärzteblatt international. 2009;106(25):416–422.
    1. Fruitman DS, MacDougall CE, Ross DB. Cardiac surgery in octogenarians: can elderly patients benefit? Quality of life after cardiac surgery. Annals of Thoracic Surgery. 1999;68(6):2129–2135.
    1. Alexander KP, Anstrom KJ, Muhlbaier LH, et al. Outcomes of cardiac surgery in patients age >or = 80 years: results from the national cardiovascular network. Journal of the American College of Cardiology. 2000;35(3):731–738.
    1. Trummer G, Beyersdorf F. Heart surgery in the elderly. Deutsche Medizinische Wochenschrift. 2005;130(12):731–734.
    1. Shapira I, Pines A, Mohr R. Updated review of the coronary artery bypass grafting option in octogenarians: good tidings. American Journal of Geriatric Cardiology. 2001;10(4):199–204.
    1. Hassan A, Newman A, Ko DT, et al. Increasing rates of angioplasty versus bypass surgery in Canada, 1994–2005. American Heart Journal. 2010;160(5):958–965.
    1. Lee DH, Buth KJ, Martin B-J, Yip AM, Hirsch GM. Frail patients are at increased risk for mortality and prolonged institutional care after cardiac surgery. Circulation. 2010;121(8):973–978.
    1. Sündermann S, Dademasch A, Praetorius J, et al. Comprehensive assessment of frailty for elderly high-risk patients undergoing cardiac surgery. European Journal of Cardio-thoracic Surgery. 2011;39(1):33–37.
    1. Loran DB, Zwischenberger JB. Thoracic surgery in the elderly. Journal of the American College of Surgeons. 2004;199(5):773–784.
    1. Lakatta EG. Cardiovascular aging research: the next horizons. Journal of the American Geriatrics Society. 1999;47(5):613–625.
    1. Lakatta E. Aging effects on the vasculature in health: risk factors for cardiovascular disease. American Journal of Geriatric Cardiology. 1994;3(6):11–50.
    1. Priebe H-J. The aged cardiovascular risk patient. British Journal of Anaesthesia. 2000;85(5):763–778.
    1. Czernin J, Muller P, Chan S, et al. Influence of age and hemodynamics on myocardial blood flow and flow reserve. Circulation. 1993;88(1):62–69.
    1. Folkow B, Svanborg A. Physiology of cardiovascular aging. Physiological Reviews. 1993;73(4):725–764.
    1. Olivetti G, Melissari M, Capasso JM, Anversa P. Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy. Circulation Research. 1991;68(6):1560–1568.
    1. Egashira K, Inou T, Hirooka Y, et al. Effects of age on endothelium-dependent vasodilation of resistance coronary artery by acetylcholine in humans. Circulation. 1993;88(1):77–81.
    1. Amrani M, Goodwin AT, Gray CC, Yacoub MH. Ageing is associated with reduced basal and stimulated release of nitric oxide by the coronary endothelium. Acta Physiologica Scandinavica. 1996;157(1):79–84.
    1. Goodwin AT, Amrani M, Marchbank AJ, Gray CC, Jayakumar J, Yacoub MH. Coronary vasoconstriction to endothelin-1 increases with age before and after ischaemia and reperfusion. Cardiovascular Research. 1999;41(3):554–562.
    1. Miyauchi T, Yanagisawa M, Iida K, et al. Age- and sex-related variation of plasma endothelin-1 concentration in normal and hypertensive subjects. American Heart Journal. 1992;123(4):1092–1093.
    1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. Journals of Gerontology A Biological Sciences and Medical Sciences. 2001;56(3):M146–M156.
    1. Boyd CM, Xue Q-L, Simpson CF, Guralnik JM, Fried LP. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. American Journal of Medicine. 2005;118(11):1225–1231.
    1. Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB. A brief clinical instrument to classify frailty in elderly people. The Lancet. 1999;353(9148):205–206.
    1. Wolfe RR. Optimal nutrition, exercise, and hormonal therapy promote muscle anabolism in the elderly. Journal of the American College of Surgeons. 2006;202(1):176–180.
    1. Fried L, Walston J. Frailty and failure to thrive. In: Hazzard WR, Blass JP, Ettinger WH Jr., Halter JB, Ous-lander J, editors. Principles of Geriatric Gerontology. 5th edition. New York, NY, USA: McGraw Hill; 2003. pp. 1487–1502.
    1. Afilalo J, Mottillo S, Eisenberg MJ, et al. Addition of frailty and disability to cardiac surgery risk scores identifies elderly patients at high risk of mortality or major morbidity. Cardiovascular Quality and Outcomes. 2012;5:222–228.
    1. Mortasawi A, Gehle S, Yaghmaie M, et al. Early and long-term results of aortic valve replacement in patients aged 80 years and older. Herz. 2001;26(2):140–148.
    1. Di Eusanio M, Fortuna D, Cristell D, et al. Contemporary outcomes of conventional aortic valve replacement in 638 octogenarians: insights from an Italian Regional Cardiac Surgery Registry (RERIC) European Journal Cardio-Thoracic Surgery. 2012;41(6):1247–1253.
    1. Cohn LH, Narayanasamy N. Aortic valve replacement in elderly patients: what are the limits? Current Opinion in Cardiology. 2007;22(2):92–95.
    1. Brown JM, O’Brien SM, Wu C, Sikora JAH, Griffith BP, Gammie JS. Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database. Journal of Thoracic and Cardiovascular Surgery. 2009;137(1):82–90.
    1. Lee R, Li S, Rankin JS, et al. Fifteen-year outcome trends for valve surgery in North America. Annals of Thoracic Surgery. 2011;91(3):677–684.
    1. Barreto-Filho JA, Wang Y, Dodson JA, et al. Trends in aortic valve replacement for elderly patients in the United States 1999–2011. The Journal of the American Medical Association. 2013;310(19):2078–2085.
    1. Vaishnava P, Fuster V, Goldman M, Bonow RO. Surgery for asymptomatic degenerative aortic and mitral valve disease. Nature Reviews Cardiology. 2011;8(3):173–177.
    1. Bonow RO, Carabello BA, Chatterjee K, et al. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular. Circulation. 2008;118(15):e523–e661.
    1. Ashikhmina EA, Schaff HV, Dearani JA, et al. Aortic valve replacement in the elderly: determinants of late outcome. Circulation. 2011;124(9):1070–1078.
    1. Iung B, Baron G, Butchart EG, et al. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on valvular heart disease. European Heart Journal. 2003;24(13):1231–1243.
    1. Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. The New England Journal of Medicine. 2011;364(23):2187–2198.
    1. Himbert D, Descoutures F, Al-Attar N, et al. Results of transfemoral or transapical aortic valve implantation following a uniform assessment in high-risk patients with aortic stenosis. Journal of the American College of Cardiology. 2009;54(4):303–311.
    1. D’Onofrio A, Fusari M, Abbiate N, et al. Transapical aortic valve implantation in high-risk patients with severe aortic valve stenosis. Annals of Thoracic Surgery. 2011;92(5):1671–1677.
    1. Tamburino C, Capodanno D, Ramondo A, et al. Incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis. Circulation. 2011;123(3):299–308.
    1. McKellar SH, Brown ML, Frye RL, Schaff HV, Sundt TM., III Comparison of coronary revascularization procedures in octogenarians: a systematic review and meta-analysis. Nature Clinical Practice Cardiovascular Medicine. 2008;5(11):738–746.
    1. Nissinen J, Wistbacka J-O, Loponen P, et al. Coronary artery bypass surgery in octogenarians: long-term outcome can be better than expected. Annals of Thoracic Surgery. 2010;89(4):1119–1124.
    1. Filsoufi F, Rahmanian PB, Castillo JG, Chikwe J, Silvay G, Adams DH. Results and predictors of early and late outcomes of coronary artery bypass graft surgery in octogenarians. Journal of Cardiothoracic and Vascular Anesthesia. 2007;21(6):784–792.
    1. Baskett R, Buth K, Ghali W, et al. Outcomes in octogenarians undergoing coronary artery bypass grafting. Canadian Medical Association Journal. 2005;172(9):1183–1186.
    1. Nicolini F, Molardi A, Verdichizzo D, et al. Coronary artery surgery in octogenarians: evolving strategies for the improvement in early and late results. Heart and Vessels. 2012;27:559–567.
    1. Mullany CJ, Darling GE, Pluth JR, et al. Early and late results after isolated coronary artery bypass surgery in 159 patients aged 80 years and older. Circulation. 1990;82(5):IV229–IV236.
    1. Singh M, Mathew V, Garratt KN, et al. Effect of age on the outcome of angioplasty for acute myocardial infarction among patients treated at the Mayo Clinic. American Journal of Medicine. 2000;108(3):187–192.
    1. Rogers WJ, Alderman EL, Chaitman BR, et al. Bypass Angioplasty Revascularization Investigation (BARI): baseline clinical and angiographic data. American Journal of Cardiology. 1995;75(9):9C–17C.
    1. Hoffman SN, TenBrook JA, Jr., Wolf MP, Pauker SG, Salem DN, Wong JB. A meta-analysis of randomized controlled trials comparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty: one- to eight-year outcomes. Journal of the American College of Cardiology. 2003;41(8):1293–1304.
    1. Gunn J, Kuttila K, Vasques F, et al. Comparison of results of coronary artery bypass grafting versus percutaneous coronary intervention in octogenarians. American Journal of Cardiology. 2012;110(8):1125–1129.
    1. Wongcharoenkiat N, Tresukosol D, Laksanabunsong P, Udompunturak S. A comparison of outcomes between percutaneous coronary intervention versus coronary artery bypass surgery in octogenarian patients. Journal of the Medical Association of Thailand. 2012;95(supplement 2):S154–S164.
    1. Ben-Gal Y, Finkelstein A, Banai S, et al. Surgical myocardial revascularization versus percutaneous coronary intervention with drug-eluting stents in octogenarian patients. The Heart Surgery Forum. 2012;15(4):E204–E209.
    1. Pfisterer M. Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary-artery disease (TIME): a randomised trial. The Lancet. 2001;358(9286):951–957.
    1. Graham MM, Ghali WA, Faris PD, Galbraith PD, Norris CM, Knudtson ML. Survival after coronary revascularization in the elderly. Circulation. 2002;105(20):2378–2384.
    1. Batchelor WB, Anstrom KJ, Muhlbaier LH, et al. Contemporary outcome trends in the elderly undergoing percutaneous coronary interventions: results in 7,472 octogenarians. Journal of the American College of Cardiology. 2000;36(3):723–730.
    1. De Gregorio J, Kobayashi Y, Albiero R, et al. Coronary artery stenting in the elderly: short-term outcome and long- term angiographic and clinical follow-up. Journal of the American College of Cardiology. 1998;32(3):577–583.
    1. Kowalchuk GJ, Siu SC, Lewis SM. Coronary artery disease in the octogenarian: angiographic spectrum and suitability for revascularization. American Journal of Cardiology. 1990;66(19):1319–1323.
    1. Klein LW, Block P, Brindis RG, et al. Percutaneous coronary interventions in octogenarians in the American College of Cardiology-National Cardiovascular Data Registry: development of a nomogram predictive of in-hospital mortality. Journal of the American College of Cardiology. 2002;40(3):394–402.
    1. Hermiller JB, Nikolsky E, Lansky AJ, et al. Clinical and angiographic outcomes of elderly patients treated with everolimus-eluting versus paclitaxel-eluting stents: three-year results from the SPIRIT III randomised trial. EuroIntervention. 2011;7(3):307–313.
    1. Hedeshian MH, Namour N, Dziadik E, Stewart RD, Campos CT. Does increasing age have a negative impact on six-month functional outcome after coronary artery bypass? Surgery. 2002;132(2):239–244.
    1. Natarajan A, Samadian S, Clark S. Coronary artery bypass surgery in elderly people. Postgraduate Medical Journal. 2007;83(977):154–158.
    1. Zingone B, Gatti G, Rauber E, et al. Early and late outcomes of cardiac surgery in octogenerians. Annals of Thoracic Surgery. 2009;87(1):71–78.
    1. Maganti M, Rao V, Brister S, Ivanov J. Decreasing mortality for coronary artery bypass surgery in octogenarians. Canadian Journal of Cardiology. 2009;25(2):e32–e35.
    1. Hlatky MA, Boothroyd DB, Bravata DM, et al. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. The Lancet. 2009;373(9670):1190–1197.
    1. Wilson MF, Baig MK, Ashraf H. Quality of life in octagenarians after coronary artery bypass grafting. American Journal of Cardiology. 2005;95(6):761–764.
    1. Dacey LJ, Likosky DS, Ryan TJ, Jr., et al. Long-term survival after surgery versus percutaneous intervention in octogenarians with multivessel coronary disease. Annals of Thoracic Surgery. 2007;84(6):1904–1911.
    1. Contini GA, Nicolini F, Fortuna D, et al. Five-year outcomes of surgical or percutaneous myocardial revascularization in diabetic patients. International Journal of Cardiology. 2013;168(2):1028–1033.
    1. Artinian NT, Duggan C, Miller P. Age differences in patient recovery patterns following coronary artery bypass surgery. American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses. 1993;2(6):453–461.
    1. Rumsfeld JS, Magid DJ, O’Brien M, et al. Changes in health-related quality of life following coronary artery bypass graft surgery. Annals of Thoracic Surgery. 2001;72(6):2026–2032.
    1. Shan L, Saxena A, McMahon R, Newcomb A. Coronary artery bypass graft surgery in the elderly. A review of postoperative quality of life. Circulation. 2013;128:2333–2343.
    1. Raja SG, Dreyfus GD. Impact of off-pump coronary artery bypass surgery on postoperative renal dysfunction: current best available evidence. Nephrology. 2006;11(4):269–273.
    1. Raja SG, Berg GA. Impact of off-pump coronary artery bypass surgery on systemic inflammation: current best available evidence. Journal of Cardiac Surgery. 2007;22(5):445–455.
    1. Marti L, Cervera C, Filella X, Marin JL, Almela M, Moreno A. Cytokine-release patterns in elderly patients with systemic inflammatory response syndrome. Gerontology. 2007;53(5):239–244.
    1. Parolari A, Alamanni F, Cannata A, et al. Off-pump versus on-pump coronary artery bypass: meta-analysis of currently available randomized trials. Annals of Thoracic Surgery. 2003;76(1):37–40.
    1. Reston JT, Tregear SJ, Turkelson CM. Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting. Annals of Thoracic Surgery. 2003;76(5):1510–1515.
    1. Raja SG, Dreyfus GD. Impact of off-pump coronary artery bypass surgery on postoperative renal dysfunction: current best available evidence. Nephrology. 2006;11(4):269–273.
    1. Saleh HZ, Shaw M, Fabri BM, Chalmers JAC. Does avoidance of cardiopulmonary bypass confer any benefits in octogenarians undergoing coronary surgery? Interactive Cardiovascular and Thoracic Surgery. 2011;12(3):435–439.
    1. LaPar DJ, Bhamidipati CM, Reece TB, Cleveland JC, Kron IL, Ailawadi G. Is off-pump coronary artery bypass grafting superior to conventional bypass in octogenarians? Journal of Thoracic and Cardiovascular Surgery. 2011;141(1):81–90.
    1. Jensen BØ, Rasmussen LS, Steinbrüchel DA. Cognitive outcomes in elderly high-risk patients 1 year after off-pump versus on-pump coronary artery bypass grafting. A randomized trial. European Journal of Cardio-thoracic Surgery. 2008;34(5):1016–1021.
    1. Tugtekin S, Kappert U, Alexiou K, Wilbring M, Nagpal AD, Matschke K. Coronary artery bypass grafting in octogenarians—outcome with and without extracorporeal circulation. Thoracic and Cardiovascular Surgeon. 2007;55(7):407–411.
    1. Meco M, Biraghi T, Panisi P, Casselman F, Cosseta D, Cirri S. Aortocoronary bypass grafting in high-risk patients over 75 years. Propensity score analysis of on versus off-pump early and midterm results. Journal of Cardiovascular Surgery. 2007;48(3):339–347.
    1. Stamou SC, Dangas G, Dullum MKC, et al. Beating heart surgery in octogenarians: perioperative outcome and comparison with younger age groups. Annals of Thoracic Surgery. 2000;69(4):1140–1145.
    1. Puskas JD, Winston AD, Wright CE, et al. Stroke after coronary artery operation: incidence, correlates, outcome, and cost. Annals of Thoracic Surgery. 2000;69(4):1053–1056.
    1. Athanasiou T, Al-Ruzzeh S, Kumar P, et al. Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients. Annals of Thoracic Surgery. 2004;77(2):745–753.
    1. Panesar SS, Athanasiou T, Nair S, et al. Early outcomes in the elderly: a meta-analysis of 4921 patients undergoing coronary artery bypass grafting—Comparison between off-pump and on-pump techniques. Heart. 2006;92(12):1808–1816.
    1. Zamvar V, Williams D, Hall J, et al. Assessment of neurocognitive impairment after off-pump and on-pump techniques for coronary artery bypass graft surgery: prospective randomised controlled trial. British Medical Journal. 2002;325(7375):1268–1271.
    1. Lee JD, Lee SJ, Tsushima WT, et al. Benefits of off-pump bypass on neurologic and clinical morbidity: a prospective randomized trial. Annals of Thoracic Surgery. 2003;76(1):18–26.
    1. Athanasiou T, Aziz O, Mangoush O, et al. Do off-pump techniques reduce the incidence of postoperative atrial fibrillation in elderly patients undergoing coronary artery bypass grafting? Annals of Thoracic Surgery. 2004;77(5):1567–1574.
    1. Athanasiou T, Aziz O, Mangoush O, et al. Does off-pump coronary artery bypass reduce the incidence of post-operative atrial fibrillation? A question revisited. European Journal of Cardio-thoracic Surgery. 2004;26(4):701–710.
    1. Maitra G, Ahmed A, Rudra A, et al. Renal dysfunction after off-pump coronary artery bypass surgery- risk factors and preventive strategies. Indian Journal of Anaesthesia. 2009;53(4):401–407.
    1. Weerasinghe A, Athanasiou T, Al-Ruzzeh S, et al. Functional renal outcome in on-pump and off-pump coronary revascularization: a propensity-based analysis. Annals of Thoracic Surgery. 2005;79(5):1577–1583.
    1. Nigwekar SU, Kandula P, Hix JK, Thakar CV. Off-pump coronary artery bypass surgery and acute kidney injury: a meta-analysis of randomized and observational studies. American Journal of Kidney Diseases. 2009;54(3):413–423.
    1. Kleisli T, Cheng W, Jacobs MJ, et al. In the current era, complete revascularization improves survival after coronary artery bypass surgery. Journal of Thoracic and Cardiovascular Surgery. 2005;129(6):1283–1291.
    1. Bonow RO, Carabello BA, Chatterjee K, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease) Circulation. 2008;118(15):e523–e661.
    1. Gammie JS, Sheng S, Griffith BP, et al. Trends in mitral valve surgery in the United States: results from The Society of Thoracic Surgeons Adult Cardiac Database. Annals of Thoracic Surgery. 2009;87(5):1431–1439.
    1. Alfieri O, Maisano F. Mitral valve surgery in the elderly: new insights and unanswered questions. European Heart Journal. 2011;32(5):535–536.
    1. Sutton MG, Gorman RC. Surgery for asymptomatic severe mitral regurgitation in the elderly: Early surgery or wait and watch? Circulation. 2006;114(4):258–260.
    1. Rosenhek R, Rader F, Klaar U, et al. Outcome of watchful waiting in asymptomatic severe mitral regurgitation. Circulation. 2006;113(18):2238–2244.
    1. Chikwe J, Goldstone AB, Passage J, et al. A propensity score-adjusted retrospective comparison of early and mid-term results of mitral valve repair versus replacement in octogenarians. European Heart Journal. 2011;32(5):618–626.
    1. Ailawadi G, Swenson BR, Girotti ME, et al. Is mitral valve repair superior to replacement in elderly patients? Annals of Thoracic Surgery. 2008;86(1):77–86.
    1. Daneshmand MA, Milano CA, Rankin JS, et al. Influence of patient age on procedural selection in mitral valve surgery. Annals of Thoracic Surgery. 2010;90(5):1479–1485.
    1. Thourani VH, Weintraub WS, Guyton RA, et al. Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement: effect of age and concomitant coronary artery bypass grafting. Circulation. 2003;108(3):298–304.
    1. Lorusso R, Gelsomino S, Vizzardi E, et al. Mitral valve repair or replacement for ischemic mitral regurgitation? The Italian Study on the Treatment of Ischemic Mitral Regurgitation (ISTIMIR) The Journal of Thoracic and Cardiovascular Surgery. 2013;145(1):128–139.
    1. Gillinov AM, Blackstone EH, Nowicki ER, et al. Valve repair versus valve replacement for degenerative mitral valve disease. Journal of Thoracic and Cardiovascular Surgery. 2008;135(4):885–893.
    1. Chikwe J, Filsoufi F. Durability of tissue valves. Seminars in Thoracic and Cardiovascular Surgery. 2011;23(1):18–23.
    1. Badhawar V, Peterson ED, Jacob JP, et al. Longitudinal outcome of isolated mitral repair in older patients: results from 14,604 procedures performed from 1991 to 2007. The Annals of Thoracic Surgery. 2012;94(6):1870–1879.
    1. Feldman T. Proceedings of TCT: current status of catheter-based mitral valve repair therapies. Journal of Interventional Cardiology. 2006;19(5):396–400.
    1. Maisano F, Buzzatti N, Taramasso M, Alfieri O. Mitral transcatheter technologies. Rambam Maimonides Medical Journal. 2013;4(3):p. e0015.
    1. Tsai TT, Trimarchi S, Nienaber CA. Acute aortic dissection: perspectives from the International Registry of Acute Aortic Dissection (IRAD) European Journal of Vascular and Endovascular Surgery. 2009;37(2):149–159.
    1. Chen Y-C, Hsu R-B. Aortic surgery requiring hypothermic circulatory arrest in octogenarians. Journal of the Formosan Medical Association. 2008;107(5):412–418.
    1. Apostolakis E, Koletsis EN, Dedeilias P, et al. Antegrade versus retrograde cerebral perfusion in relation to postoperative complications following aortic arch surgery for acute aortic dissection type A. Journal of Cardiac Surgery. 2008;23(5):480–487.
    1. Neri E, Toscano T, Massetti M, et al. Operation for acute type A aortic dissection in octogenarians: is it justified? Journal of Thoracic and Cardiovascular Surgery. 2001;121(2):259–267.
    1. Hata M, Sezai A, Niino T, et al. Should emergency surgical intervention be performed for an octogenarian with type A acute aortic dissection? Journal of Thoracic and Cardiovascular Surgery. 2008;135(5):1042–1046.
    1. Piccardo A, Regesta T, Zannis K, et al. Outcomes after surgical treatment for type A acute aortic dissection in octogenarians: a multicenter study. Annals of Thoracic Surgery. 2009;88(2):491–497.
    1. Biancari F, Vasques F, Benenati V, Juvonen T. Contemporary results after surgical repair of type A aortic dissection in patients aged 80 years and older: a systematic review and meta-analysis. European Journal of Cardio-thoracic Surgery. 2011;40(5):1058–1063.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner