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OC58 PRELIMINARY RESULTS OF MITRAL VALVE SURGERY IN OCTOGENARIANS

A GIROC MULTICENTER STUDY

Stura, E. Cura1; Ricci, D.1; Paparella, D.2; Nicolardi, S.3; Vanelli, P.4; Casali, G.5; Antona, C.6; Rinaldi, M.1

Journal of Cardiovascular Medicine: November 2018 - Volume 19 - Issue - p e12
doi: 10.2459/01.JCM.0000549878.41825.ff
4. ORAL PRESENTATION - MULTICENTRE TRIAL STUDIES SATURDAY 24 - 10.30-12.00: PDF Only
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Objective: In this multicenter prospective study we sought to analyze preliminary results of high risk old patients who underwent mini-invasive mitral valve surgery.

Methods: From January 2016 to March 2018, 38 patients ≥80 years old underwent MV surgery: mean EuroSCORE II was 4.5 ± 3.7, mean predictive mortality according to logistic Euroscore was 15.4 ± 11.2%. Male were 47.4%, mean BMI was 23.8 ± 3.5. Main MV etiology was degenerative (76.3%). Comorbidities included: diabetes (13.2%), COPD (10.5%), CRF (15.8%), peripheral vasculopathy (21.1%) and AF (60.5%). Mean pre-operative EF was 59.9 ± 10.1% and severe pulmonary hypertension (≥ 55 mmHg) was present in 36.8% of the cases. Patients who underwent previous cardiac operation were 2.6 %. A preoperative vascular screening of the aorta was perfomed in 81.6% patients.

Results: All patients except one (97.4%) underwent mini-invaive mitral valve surgery. Mitral repair was obtained in 12 out of 38 patients. Main associated procedures were TV repair (15.8%), ASD closure (13.2%) and AF-crioablation (7.9%). Mean cardiopulmonary and cross-clamping time were respectively 122.7 ± 34.4 and 85.2 ± 24.5 minutes. Aortic clamping was obtained with either Chitwood clamp (94.5%) or endoballoon (5.5%). Conversion to sternotomy was necessary in only one case. Operative mortality was 0%. Reoperation for bleeding, aortic dissection and major neurologic events were not reported. 34.2% of the patients required blood transfusion, 5.3% emodyalisis and 5.3% PM implantation. Mean ventilatory support, ICU and hospital stay were respectively 14.5 ± 14 h, 3.3 ± 5.7days and 10.0 ± 5.8days. 30-day mortality was 2.6%.

Preliminary Conclusions: mini-invasive approach allows acceptable morbidity and mortality in octogenarian patients.

1Cardiochirurgia U A.O.U. “Città della Salute e della Scienza di Torino” Torino

2Cardiochirurgia Ospedale “Santa Maria” Bari

3Cardiochirurgia Ospedale “Vito Fazzi” Lecce

4Cardiochirurgia Ospedale “Luigi Sacco” Milano

5Cardiochirurgia Ospedale “Vito Fazzi” Lecce

6Cardiochirurgia Ospedale “Sacco” Milano

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