DIRECT OUTCOMES OF SURGICAL TREATMENT OF VALVULAR HEART DISEASES IN PATIENTS OF 75 YEARS AND OLDER: RISK FACTORS AND PREDICTORS OF HOSPITAL MORTALITY
Objective - to evaluate direct outcomes of surgical treatment of valvular heart disease in patients of 75 years of age and older. Material and methods. The purpose of this study was to evaluate direct outcomes of surgical treatment of valvular heart disease in patients of 75 years of age and older, to analyze risk factors and predictors of hospital mortality. From 2008 to 2015 open heart surgery was performed on 198 senile age patients. The mean age of patients was 77 years ± 2 (75 to 86 years). Predominant etiological factors were degenerative valve disease - in 108 (54.5%) patients, congenital heart defects (myxomatous valvular degeneration and bicuspid aortic valve) - 54 (27.3%) patients, rheumatic heart disease - in 19 (9.6%) patient, infective endocarditis and ischemic mitral regurgitation. 1 valve surgery was performed on 90 (45.5%) patients, 2 valves surgery - 33 (16.6%) patients, 3 valves surgery - 14 (7.1%) patients, concomitant cardiac surgery (heart valve repair/ replacement + CABG) - 61 (30.8%) patients. Results. Postoperative mortality rate was 14.6% (29 patients). Statistically significant predictors of hospital mortality were: the exceeded duration of cardiopulmonary bypass and of aortic cross-clamping, intraoperative blood loss > 500 ml, low cardiac output syndrome, development of acute renal failure on the second postoperative day, having required hemodialysis, оbesity, left ventricular output fraction <45%, EuroSCORE. The mean postoperative length of hospital stay was 15 ± 10 days. 160 (80.8%) patients were discharged from hospital in a good state and 9 (4.5%) patients were transferred to local hospitals for follow-up care and rehabilitation. Conclusion. The study concluded that despite high risk of surgical intervention and comorbidity at the present time valvular heart surgery in patients of 75 years of age and older can achieve satisfactory results.