HEART VALVE REPLACEMENT IN THE ELDERLY / 解放军医学杂志

ABSTRACT

patients aged from 60 to 78 years underwent heart valve replacement, and all of the valves were replaced with mechanical valve except 2 with bioprothesis. Among them there were 4 groups mitral valve replacement in 14, aortic valve replacement in 10, double valves replacement in 13, and modified Bentall′s procedure in 3. Coronary angiography was performed routinely before operation, and coronary artery bypass grafting were performed in 7.The overall mortality rate was 5.0%. 1 case was complicated by Ⅲ? atrial ventricular block 18 days after operation, and a permanent pacemaker was implanted. No other serious postoperative complication occurred. 33 cases were followed up from 4 months to 7 years.It was found that cardiac function got better significantly in all the patients,and no one died within that period. The results suggested that①Good result was obtained in cardiac valve replacement in the elderly; single geriatric factor did not seem to be a contraindication for cardiac valve replacement. ②Coronary angiography should be performed as a routine; all the patients with significant stenosis of the coronary artery should undergo coronary artery bypass grafting. ③All the parameters of physiological demand should be more strictly observed in undertaking the operation. ④The reservation of the organ function declines in the elderly,thus multiorgan insufficiency was prone to occur after the operation, therefore prevention and treatment of the complications is the key to have a successfully rehabilitation.