84.14 Outcomes on Double Heart Valve Operations for Octogenarians

A.K. Landrum1, J.E. Davies1, C.T. Lewis1, R. Xie1, M. Ahmed2, M. Sabouni2, H. Abu Daya2, A. Zaky3, P.N. Vardas1  1University Of Alabama at Birmingham, Division Of Cardiothoracic Surgery, Birmingham, Alabama, USA 2University Of Alabama at Birmingham, Division Of Interventional And Structural Cardiology, Birmingham, Alabama, USA 3University Of Alabama at Birmingham, Division Of Cardiac Anesthesia, Birmingham, Alabama, USA

Introduction: Multivalvular heart disease is associated with significant morbidity and mortality. As life expectancy increases, the number of octogenarians being evaluated for surgical intervention of valvular heart disease has grown. Single valve operations in octogenarians have shown acceptable to excellent outcomes. However, there is an underrepresentation of data on the viability of double valve operations in octogenarians.

Methods:  In this study, we will utilize the Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD) spanning from July 2019 to December 2023 to extract demographic information, comorbidities, and pre-operative, operative, and post-operative clinical characteristics of the eligible study population. Our statistical analysis employed descriptive statistics to summarize the data, and, where appropriate, we conducted univariate, bivariate, or multivariable analyses to explore the associations and outcomes within the dataset. The primary outcomes were defined as mortality and stroke. The secondary outcomes were defined as major adverse cardiac events (MACE), length of stay (LOS), permanent pacemaker, respiratory failure, and dialysis. 

Results: A total of 14 octogenarian patients underwent simultaneous double valve operations at our institution between 2019 and 2023. Of these, 9 operations were combined aortic valve replacement (AVR) and mitral valve replacement (MVR), 3 were AVR and MVR with coronary artery bypass grafting (CABG), 1 was re-operative AVR and re-operative MVR with CABG, and 1 was AVR and tricuspid valve replacement. The all-cause post-operative mortality was 7.1% (n=1). Stroke complications were 0.0% (n=0). Of secondary outcomes, MACE was 0.0% (n=0), permanent pacemaker and dialysis were 7.1% (n=1), and prolonged ventilation was 14.3% (n=2). The median LOS was 8 days with 25th and 75th percentiles of 7 days and 20 days, respectively. 

Conclusion: Double valve operations in octogenarians are associated with acceptable morbidity and mortality. Our data shows that surgical intervention of multivalvular disease should not be avoided solely due to age.