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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
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L. Cardiovascular Pharmacology
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Aortic valve surgery in octogenarians
Session:
Posters 5 - Écran 8 - Doença Valvular
Speaker:
Renata Melo Raimundo
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Renata Raimundo; Francisca Saraiva; Soraia Moreira; Rui Cerqueira; André Lourenço; Mário J. Amorim; Jorge Almeida; Paulo Pinho; Adelino Leite-Moreira
Abstract
<p><strong>Background</strong></p> <p>The number of octogenarians referred to aortic valve replacement (AVR) is growing due to aging of population.</p> <p><strong>Aim </strong></p> <p>To evaluate early outcomes and survival after AVR surgery in octogenarians.</p> <p><strong>Methods</strong></p> <p>Single-center retrospective cohort study including consecutive AVR surgery in octogenarian patients with last-generation bioprostheses implanted from 2009 to 2016 in a. Absolute and relative frequencies and mean or median were used to sample characterization. Mid-term cumulative survival estimate was done using Kaplan-Meier curve. Median follow-up time was 28 months (maximum 91 months).</p> <p><strong>Results</strong></p> <p>We included 205 patients with mean age of 82±2 years, 55% being female. Median of EuroSCORE II was 4.3 (1.1-50.6), being significantly higher in patients with multiple procedures (n=106, 6.6% (2.0 to 50.6) <em>vs</em>. n=99, 2.8% (1.1 to 20.3), p <0.001). The most common risk factors were arterial hypertension (84.4%) and dyslipidemia (63.4%). Only 14.6% patients had history of smoking. During surgery two patients required intraortic balloon pump (IABP). In the immediate postoperative period, inotropic support (≥2 amines, or IABP) was required in 47(22.9%) patients and 12.4% needed prolonged ventilation (>24hours). De novo atrial fibrillation episodes occurred in 82 (51.3%) patients, and 8 (3.9%) patients suffered a clinically relevant stroke. Complete heart block occurred in 26 (12,8%) individuals and 11 (5.6%) required implantation of permanent pacemaker (for all cause). Worsening of renal function (postoperative 50% increasing considering basal creatinine) occurred in 9 (4.4%) patients. The median of hospital stay was 9 days (3 to 115 days). One patient underwent early reoperation (30 days post-implant) due to endocarditis. Intra-operative mortality was 0% and 30-days mortality was 5.8% (3.0% vs. 8.5% in isolated <em>vs</em>. multiple procedures, p=0.096). The 1-, 3- and 5-years cumulative survival were 88%, 75% and 58% respectively.</p> <p><strong>Conclusion</strong></p> <p>Our findings support the benefit of surgical AVR in octogenarians, considering the low incidence of complications and reasonable mid-term survival.</p>
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