Hochberg M S, Morrow A G, Michaelis L L, McIntosh C L, Redwood D R, Epstein S E
Arch Surg. 1977 Dec;112(12):1475-80. doi: 10.1001/archsurg.1977.01370120065007.
Seventy-three patients aged 60 and over and 277 patients under 60 years of age underwent isolated aortic valve replacement (AVR) for aortic stenosis, regurgitation, and mixed disease from 1966 through 1975. Cardiac catheterization was performed five to nine months following operation in 77% of these patients. Follow-up averaged 55 months per patient. The hospital mortality in the elderly group was 2.7%, compared to 5.8% in the younger group. The late cardiac mortality was 21% and 19%, respectively. There was significant improvement (P less than .001) in the left ventricular end-diastolic pressure, cardiac index, and functional class in each of the three disease groups in the younger as well as the elderly patients. More important, the magnitude of improvement in each of these variables in patients over and under 60 years of age was not significantly different. Increasing longevity will make cardiac operations more common in the older population. These findings indicate that AVR carries the same low risk and brings about a similar improvement in left ventricular pump function in patients older and younger than 60.
1966年至1975年期间，73例60岁及以上患者和277例60岁以下患者因主动脉瓣狭窄、反流及混合性疾病接受了单纯主动脉瓣置换术（AVR）。其中77%的患者在术后5至9个月进行了心导管检查。每位患者的随访平均时长为55个月。老年组的医院死亡率为2.7%，而年轻组为5.8%。晚期心脏死亡率分别为21%和19%。年轻患者和老年患者的三个疾病组中，左心室舒张末期压力、心脏指数和心功能分级均有显著改善（P<0.001）。更重要的是，60岁以上和60岁以下患者在这些变量上的改善程度无显著差异。预期寿命的增加将使心脏手术在老年人群中更为常见。这些发现表明，AVR在60岁以上和60岁以下患者中具有相同的低风险，并能使左心室泵功能得到类似的改善。
