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Geriatric factors associated with one year mortality after aortic valve replacement Dr Anne Sophie Boureau Department of Geriatrics Nantes University Hospital, France

CONFLICT OF INTEREST DISCLOSURE I have no potential conflict of interest to report

Mortality after AVR Other cardiac factors as pulmonary hypertension, concomitant cardiac surgery, coronary disease.

Geriatrics factors and SAVR

Aim of study Identify geriatric factors associated with one year mortality after a surgical aortic valve replacement among older patients with severe symptomatic aortic stenosis. • Retrospective analysis of data collected prospectively from 2012 to 2014 • Nantes University Hospital • Inclusion criteria : – Aged ≥ 75 years – SAVR for aortic valve stenosis +/- other cardiac surgery – Comprehensive pre-operative geriatric assessment

Multivariate analysis Factors associated with one year HR (95% IC) p-value mortality Pulmonary Hypertension 3.73 (1.05-13.33) 0.04 Concomitant CABG or other valve 6.22 (1.17-32.98) 0.03 replacement Prior cardiac surgery 10.47 (1.27-86.49) 0.03 Mini-mental status exam 4.67 (1.09-20.13) 0.04 (Cox regression model )

Discussion • Cognitive impairment – Studies on long term cognitive decline, but not on mortality – Associated with post-operative delirium, and delirium associated with mortality (Maniar et al ., J Thorac Cardiovasc Surg, 2016)

Discussion • Gait function: – No study with Timed up and Go test – Previous study with gait speed (Afilalo et al., JACC, 2010) • Nutritional status: – Very few malnourished patients

Limitations Strength • Inherent to a retrospective Results consistent with analysis previous studies : • Single institution • One year mortality rate (9,6%) • CGA results knowned by all • Cardiac predictors praticians including surgeons associated with mortality (Brennan et al, Circulation, 2012 Di Eusanio et al, J Thorac Cardio Surg, 2011)

Messages • First study including all geriatrics factors • Association between cognitive impairment and one year mortality after SAVR