Is Heart Valve Surgery Advisable For Elderly Patients Over Eighty Years Old?
I just received an email from Mel, an eighty year old patient that requires aortic valve replacement. Mel wrote to me, “Adam - I am 80 years old and will need an aortic valve replacement in the coming months. Do you have any experience with people in my age bracket who have had this replacement. What has been their experience?”
This is one of the more common questions I receive from elderly patients and caregivers of elderly patients needing heart valve repair or heart valve repair surgery. Recently, some interesting information has been published about this exact topic - valve surgery in those over eighty years old.
In one new study, it was found that age should not disqualify elderly patients from having heart valve surgery.
Dr. Farzan Filsoufi and colleagues from the Mount Sinai School of Medicine in New York City found that patients 80 years of age or older who underwent aortic valve replacement fared nearly as well as younger patients, according to Reuters Health.
With the aging of the population (e.g. the baby boomers), valve surgery is expected to become more common in the United States. In this new report, published in Journal of the American Geriatrics Society, researchers reviewed the records of 1,308 consecutive patients who underwent the procedure at Mount Sinai between 1998 and 2006. Of these patients, 17.6 percent were 80 or older. The report found that older patients were no more likely to die in the hospital than the younger patients.
There were some elements of the report that did uncover some challenges for the elderly patients following heart valve surgery.
- Elderly patients did have a greater risk of respiratory failure
- Elderly patients spent an average of 10 days while younger patients stay five days less.
The real good news of the report? About two thirds of the oldest patients lived for at least 5 years after the operation, a rate of survival comparable to people of the same age in the general population. Dr. Filsoufi believes that the advances in cardiac surgery technology is the key reason for the positive findings of the study. And, he believes that less invasive surgical techniques (percurtaneous, robotics) may enhance the elderly results further.
I hope that helps answer Mel’s question about heart valve surgery for the elderly.
Keep on tickin!
Adam Pick is a former, double heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery. This special book was designed to help patients and caregivers better understand the opportunities and potential pitfalls of heart valve replacement and heart valve repair surgery. Ultimately, this book was written to minimize patient stress and to enhance the patient’s recovery. To learn more about Adam’s heart valve surgery book, click here.
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April 14th, 2008 at 9:51 pm
Can an eighty year old patient that requires an Aortic valve replacement be a candidate for the minimally invassive procedure?
Mel
April 15th, 2008 at 8:35 am
Hi Mel,
I believe the answer to that is a definite yes. In fact, one of the benefits of the minimally invasive procedures is that the recovery takes less time since the procedure can be non-invasive (or less invasive than a median sternotomy in which the patient’s chest plate is broken).
However, each heart valve surgery procedure is performed on a case by case basis. So, please talk this over with your surgeon.
Keep on tickin!
Adam
February 25th, 2009 at 7:32 pm
What do you think of a 90-year-old man who has critical aortic stenosis, severe mitral valve regurgitation, and needs 1 bypass? Amazingly enough, he is asymptomatic!
Based on your research, do you think he should postpone surgery as long as he is asymptomatic, do the surgery now, or forget surgery? He is otherwise healthy and mentally sharp.
Have you found any data on 90+ patients and open-heart surgery? A valvuloplasty didn’t help, and he will probably be turned down for a percutaneous clinical trial aortic valve because of the mitral valve problem. I think even the doctors are stumped.