Urgent Aortic Valve Replacement in Octogenarians: Does an 'Urgent' Status Increase Morbidity and Mortality?

Background and aim of the study: The study aim was to investigate the influence of 'urgent' status on short and long-term mortality and morbidity in a consecutive series of octogenarian patients who underwent aortic valve replacement (AVR). Methods: Between January 2005 and March 2009, data were extracted for 141 consecutive patients aged over 80 years who underwent AVR either urgently (n = 49) or electively (n = 92). Early outcomes (in-hospital mortality, postoperative morbidities) and long-term outcomes were compared during a 39-month follow up period. The outcomes were compared after adjustment for differences in baseline risk factors. Results: Patients of the 'urgent' group were older and had more comorbidities than those in the 'elective' group. There was a non-significant trend towards a higher in-hospital mortality in the 'urgent' group (10.2% versus 4.3%, p = 0.18). The 39-month survival rate was 81% in elective patients, and 71% in urgent patients (p = 0.166). Conchision: AVR can be performed in the elderly population with acceptable early and mid-term results, despite their urgent status. A large clinical trial is warranted to confirm the influence of an urgent status in octogenarian patients treated with surgical AVR.