Short and medium-term surgical treatment effects of cardiac valve disease for patients more than 68 years old

Objective To retrospectively evaluate the outcome of valvular surgery for the elder patients and to summarize the clinical experience of surgery and perioperative period. Methods From March, 2016 to September, 2017, 25 elderly patients (≥ 68) underwent valvular operations in our hospital, including 16 male and 9 females. There were 18 cases of rheumatic valvular heart disease, 2 cases of infective endocarditis and 5 cases of senile degenerative valvular disease. A total of 14 patients had Mitral valve replacement (MVR), 5 had aortic valve replacement (AVR), 2 had MVR plus AVR, 2 had MVR combined with coronary artery bypass grafting (CABG), 1 had AVR plus CABG combined with ascending aorta replacement, and 1 had AVR combined with mitral valve repair. The other concomitant operation included 11 cases of tricuspid valve repair, 1 atrial thrombus clearance plus resection of left atrial appendage, and 1 left atrial myxoma resection. Results The time of cardiopulmonary bypass time (CPB), aortic cross-clamp, postoperative ventilator, postoperative care, and postoperative hospital stay were (126.2±57.2) min, (72.3±48.2)min, (15.24±6.91)h, (49.12±18.82)h, and (9.5±4.2) days respectively. The operative mortality was 4%. Operation complications included 7 cases of arrhythmia, 2 pulmonary infections, 1 postoperative hemorrhage, and 1 wound dehiscence. After the operation, the cardiac function of the patients was improved significantly, and the activity ability was improved in different degrees. Follow-up time was 1-18 months, 1 patient died of pulmonary infection 7 months after MVR operation. The remaining patients survived with life quality being significantly improved. Conclusion Adequate perioperative management, good myocardial protection and improved operation are safe and effective for elderly patients with valvular heart disease.