Jamieson W R, Thompson D M, Munro A I
Can Med Assoc J. 1980 Oct 7;123(7):628-32.
Cardiac valve replacement in 65 consecutive elderly patients (aged 65 years and older) revealed that the indications for cardiac valve replacement in the elderly should be the same as those in the general population. These 65 patients represented 16% of the patients undergoing valve replacement. The mortality in the first 30 days after operation was 4.6% in the elderly group, compared with 0.9% in the group under 65 years of age. There were 26 significant but nonfatal early complications in the elderly patients, but their long-term functional status was excellent, most of the survivors ending up in either class I or class II of the New York Heart Association functional classification. The late mortality was 3.9% per patient year for aortic valve replacement and 15.1% for mitral with or without aortic valve replacement. The actuarial survival rates were 88% at 24 months and 55% at 54 months for the total elderly group, 86% at 36 months for those with aortic valve replacement, 85% at 24 months and 64% at 36 months for those with mitral valve replacement, 90% at 24 months and 77% at 42 months for the men, and 82% at 24 months and 68% at 42 months for the women. Aortic valve replacement was more common in the elderly than in the younger group because of the higher prevalence of congenital calcific aortic stenosis in the former, and this operation provided more gratifying results than mitral valve replacement in the elderly patients.
对65例连续的老年患者（年龄65岁及以上）进行心脏瓣膜置换术的研究表明，老年患者心脏瓣膜置换的适应症应与普通人群相同。这65例患者占接受瓣膜置换术患者的16%。老年组术后30天内的死亡率为4.6%，而65岁以下组为0.9%。老年患者有26例严重但非致命的早期并发症，但其长期功能状态良好，大多数幸存者最终处于纽约心脏协会功能分级的I级或II级。主动脉瓣置换术的患者年晚期死亡率为3.9%，二尖瓣置换术（无论是否合并主动脉瓣置换术）为15.1%。老年患者总体的精算生存率在24个月时为88%，54个月时为55%；主动脉瓣置换术患者在36个月时为86%；二尖瓣置换术患者在24个月时为85%，36个月时为64%；男性在24个月时为90%，42个月时为77%；女性在24个月时为82%，42个月时为68%。由于老年患者先天性钙化性主动脉瓣狭窄的患病率较高，主动脉瓣置换术在老年患者中比在年轻组中更常见，并且该手术在老年患者中比二尖瓣置换术提供了更令人满意的结果。
