Doi Y
Department of Medicine & Geriatrics, Kochi Medical School.
Nihon Ronen Igakkai Zasshi. 1994 Mar;31(3):198-204.
To elucidate the surgical results and long-term prognosis in valvular heart disease, including infective endocarditis, in the elderly, 110 patients with valvular heart disease who underwent surgical treatment and 29 patients with infective endocarditis were studied. Among the patients with valvular heart disease, 52 patients (21 elderly, 31 young) underwent aortic valve replacement, 46 patients (24 elderly, 22 young) mitral valve replacement, and 12 patients (6 elderly, 6 young) double valve replacement. There were only 2 operative deaths (1 elderly, 1 young). The 5-year survival rate was 91.2% in elderly patients and 92.3% in younger patients. The five-year event-free rate was 67.3% in elderly patients and 79.0% in younger patients. Among 29 patients with infective endocarditis, surgical treatment was successfully performed in six of the 13 elderly patients and 10 of the 16 younger patients. There were two deaths among the younger patients and no death among the elderly patients, although recurrence was found in 2 elderly patients. Good results can be obtained from surgical intervention in elderly patients, provided they are risk-stratified before surgery followed by appropriate management.
为了阐明老年瓣膜性心脏病（包括感染性心内膜炎）的手术结果和长期预后，我们对110例接受手术治疗的瓣膜性心脏病患者和29例感染性心内膜炎患者进行了研究。在瓣膜性心脏病患者中，52例（21例老年患者，31例年轻患者）接受了主动脉瓣置换术，46例（24例老年患者，22例年轻患者）接受了二尖瓣置换术，12例（6例老年患者，6例年轻患者）接受了双瓣膜置换术。手术死亡仅2例（1例老年患者，1例年轻患者）。老年患者的5年生存率为91.2%，年轻患者为92.3%。老年患者的5年无事件发生率为67.3%，年轻患者为79.0%。在29例感染性心内膜炎患者中，13例老年患者中有6例、16例年轻患者中有10例成功接受了手术治疗。年轻患者中有2例死亡，老年患者中无死亡病例，不过有2例老年患者出现复发。对于老年患者，如果在手术前进行风险分层并随后进行适当管理，手术干预可以取得良好的效果。
