Abstract:
OBJECTIVE:This study was planned to evaluate the outcome of patients ≥80 years old undergoing isolated conventional aortic valve replacement (AVR). METHODS:Systematic review of the literature and meta-analysis of data on octogenarians and nonagenarians who underwent isolated AVR were performed. RESULTS:The literature search yielded 48 observational studies reporting on 13 216 patients ≥80 years old. Pooled proportion of immediate postoperative mortality was 6.7 % (95% CI 5.8-7.5, 47 studies, 13,092 patients), and it was 5.8% (95% CI 4.8-6.9) in 18 studies with a mid-date from 2000 to 2006 and 7.5% (95% CI 6.8-8.2) in 30 studies with a mid-date from 1982 to 1999 (P = .004). Pooled proportion of postoperative stroke was 2.4% (95% CI 2.1-2.7, 21 studies, 8,436 patients), that of postoperative dialysis was 2.6% (95% CI 1.6-3.8, 10 studies, 1,945 patients), and that of postoperative implantation of a pacemaker was 4.6% (95% CI 3.6-5.8, 6 studies, 1,470 patients). Pooled survival rates at 1, 3, 5, and 10 years after isolated AVR were 87.6%, 78.7%, 65.4%, and 29.7%, respectively. CONCLUSIONS:Immediate postoperative mortality and morbidity after isolated AVR in patients ≥80 years old are rather low. Postoperatively mortality decreased even further in the most recent series. Importantly, isolated AVR in these high-risk patients was associated with good late survival. These findings suggest that advanced age alone cannot be considered as a contraindication to conventional isolated AVR and that any new valve prosthesis implanted in these patients should be durable enough to guarantee the results so far offered by conventional surgery.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Vasques F,Messori A,Lucenteforte E,Biancari Fdoi
10.1016/j.ahj.2011.12.005subject
Has Abstractpub_date
2012-03-01 00:00:00pages
477-85issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(11)00886-6journal_volume
163pub_type
杂志文章,meta分析,评审abstract::Epinephrine increases coronary blood flow but may not improve the balance between myocardial oxygen supply and demand during cardiopulmonary resuscitation (CPR). The objective of this study was to determine whether this balance can be improved by administering a relatively pure alpha-adrenergic vasoconstrictor, alone ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90120-1
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:To evaluate the impact of adjunctive high-dose glucose-insulin-potassium (GIK) on ST-segment elevation resolution in patients with ST-segment elevation myocardial infarction (MI). METHODS:As part of a randomized controlled trial of GIK versus no GIK in patients treated with primary percutaneous coronary int...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2005.03.023
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation remains a frequent complication after heart surgery. The optimal strategy to treat the condition has not been established. Several retrospective studies have suggested that a primary rate-control strategy may be equivalent to a strategy that restores sinus rhythm. METHODS:Fifty patients ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mhj.2000.111104
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:beta-blockers have been shown to benefit patients after myocardial infarction by decreasing mortality, sudden cardiac death, and reinfarction. Although beta-blockers are recommended for all patients with acute coronary syndromes (ACS) without contraindications, a target heart rate (HR) is recommended only fo...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.06.023
更新日期:2009-09-01 00:00:00
abstract::A review of the clinical course of chronic heart failure demonstrates that current outcomes remain highly unsatisfactory both in mortality and perhaps more important in morbidity. The extraordinary satisfactory functional responses seen in patients who undergo cardiac transplantation clearly identify the primary cause...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(90)90056-4
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Patients with atrial fibrillation (AF) are at increased risk for ischemic stroke. In patients who have suffered a stroke, screening for AF is routinely performed only for a short period after the stroke as part of the evaluation for possible causes. If AF is detected after an ischemic stroke, oral anticoagul...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2010.03.032
更新日期:2010-07-01 00:00:00
abstract::An acute thrombus at the proximal border of a high-grade atherosclerotic obstruction is the usual cause of myocardial infarction. Although intracoronary thrombolysis is potentially an exciting new therapy for reducing the extent of myocardial infarction by lysing coronary clot, a number of major difficulties limit its...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(82)90267-8
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:Parasympathetic dysautonomia is an established feature of advanced Chagas cardiomyopathy. However, in the absence of cardiac involvement, the presence of vagal dysfunction remains controversial. In a cross-sectional study, we compared patients with Chagas disease without cardiac involvement and healthy indiv...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2001.111406
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Recent randomized clinical trials have suggested a benefit of an invasive management strategy in patients with acute coronary syndromes. However, the broader use and impact of the invasive management approach has not been established for patients with acute coronary syndromes beyond the relatively narrow pat...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1067/mhj.2002.122517
更新日期:2002-06-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80350-5
更新日期:1977-07-01 00:00:00
abstract::The incidence of cardiac events in Japanese men (mean age 54 +/- 10 years) with atypical or nonanginal chest pain was assessed prospectively. Three groups of patients, those with typical angina (TA; n = 134), those with atypical angina (AA; n = 192), and those with nonanginal chest pain (NA; n = 311) were studied with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90802-3
更新日期:1992-06-01 00:00:00
abstract::In a prospective clinical trial of 195 consecutive unselected patients with acute myocardial infarction (AMI), systematic blinded clinical and echocardiographic examinations were performed by two observers on day 5. The purpose was to define low-risk patients with regard to in-hospital and 2-month mortality and predic...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(92)90963-v
更新日期:1992-10-01 00:00:00
abstract::We studied 16 patients with chronic aortic insufficiency to compare a method for measuring regurgitant volume with color Doppler flow mapping to stroke count ratio determined by radionuclide ventriculography and to ventricular volumes assessed by two-dimensional echocardiography. A real-time color flow map of the left...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90868-5
更新日期:1989-05-01 00:00:00
abstract::The appearance of perivalvular cavities (PCs) in patients with infectious endocarditis (IE) was studied by transesophageal echocardiography (TEE) color Doppler examinations to determine whether the color Doppler TEE presentation was in keeping with the current concept of PCs representing abscesses. Two heart centers p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90241-4
更新日期:1995-07-01 00:00:00
abstract::Digoxin intoxication has been reported to be a common adverse drug reaction with an in-hospital incidence of 6% to 23% and an associated mortality rate as high as 41%. A retrospective review was conducted to assess the accuracy of diagnosis, the morbidity and mortality of digoxin intoxication, and its incidence in hos...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90135-k
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Whether low-molecular-weight heparin (LMWH) is superior to unfractionated heparin (UFH) in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) remains unclear. METHODS:A total of 3,372 STEMI patients wh...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2009.12.041
更新日期:2010-04-01 00:00:00
abstract::Although cardiovascular disease remains the leading cause of death in the United States, cardiovascular disease mortality has decreased steadily during the past 2 decades. This trend is largely attributable to improved detection and management of cardiovascular risk factors, in which the Framingham Heart Study has pla...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80050-x
更新日期:1990-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80305-0
更新日期:1977-02-01 00:00:00
abstract::We investigated the relationship between plasma atrial natriuretic polypeptide (ANP) levels and hemodynamic indices during dynamic exercise testing in 15 patients with effort angina pectoris. Patients exercised on an angina-limited, supine, multistage bicycle ergometer, and plasma ANP levels and hemodynamic indices we...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90239-t
更新日期:1990-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2012.03.022
更新日期:2012-07-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(85)90702-1
更新日期:1985-05-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-8703(03)00407-1
更新日期:2003-11-01 00:00:00
abstract::Chronic maintenance tocainide therapy was effective in controlling symptomatic, recurrent ventricular tachycardia in 11 of 15 patients. Patients were selected for tocainide therapy on the basis of refractoriness to conventional antiarrhythmic agents and responsiveness to the intravenous administration of lidocaine. Si...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90208-2
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Practice guidelines for patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) recommend targeting evidence-based therapies for the highest-risk patients. We characterized guideline adherence for NSTE ACS by risk status. METHODS:We analyzed inhospital treatments and outcomes for 77760 ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.08.006
更新日期:2006-06-01 00:00:00
abstract::To compare the effects of two thrombolytic agents, streptokinase and recombinant tissue-type plasminogen activator (rTPA) with early heparinization, on left ventricular function, coronary patency and reinfarction rates, bleeding complications, and short- and long-term mortality, we studied 122 patients with acute myoc...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(92)90685-o
更新日期:1992-04-01 00:00:00
abstract::The prognostic significance of changes in the mode of induction of ventricular tachycardia (VT) noted during therapy was studied in 49 patients with sustained VT or ventricular fibrillation. Before treatment, all patients had inducible sustained VT by programmed stimulation (one to three extrastimuli) and frequent (gr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90189-x
更新日期:1987-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2003.163
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:During daytime working hours, outcomes may be worse when percutaneous coronary intervention (PCI) is performed later in the day because of operator fatigue and differences in process of care. METHODS:Using the APPROACH database, we analyzed 2,492 consecutive nonurgent PCI procedures performed during working...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2010.03.010
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Although the use of clopidogrel in patients "unlikely" to require coronary artery bypass grafting (CABG) is recommended in current guidelines of acute coronary syndrome (ACS) management, an important minority of patients require CABG. We assessed the ability to predict need for CABG from demographics known a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.12.002
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The relationship of changes in weight to outcomes in patients after myocardial infarction (MI) is controversial. METHODS:From the ENRICHD trial data, we assessed weight change, and the associations of baseline weight and change at follow-up with outcomes and interactions between psychosocial factors. RESUL...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.10.026
更新日期:2008-03-01 00:00:00