There is a popular perception that aortic valve replacement (AVR) in octogenarians carries a high risk related primarily to advanced age. Using the Department of Veterans Affairs Continuous Improvement in Cardiac Surgery Program, we identified patients who underwent AVR between 1991 and 2007. A prediction model was constructed using stepwise logistic regression methodology for outcome comparisons. Compared with younger patients (age<80 years; n = 6,638), older patients (age>or = 80; n = 504) had a higher prevalence of baseline comorbidities. In a comparison of patients propensity-matched by risk profile (459 from each group), the older group had a higher morbidity rate (21.1% vs 15.5%; p<0.03) but a similar mortality rate (5.2% vs 3.3%; p = 0.19) compared with the younger group.
After risk adjustment, age of 80 years or greater was independently associated with higher AVR-related morbidity but not mortality. Further work is needed to identify ways to reduce operative morbidity in the extremely elderly.
Is an age of 80 years or greater an important predictor of short-term outcomes of isolated aortic valve replacement in veterans?