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Dec 20, 2023 325 likes •466 views

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

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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

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CONFLICT OF INTEREST DISCLOSURE

I have no potential conflict of interest to report

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Mortality after AVR

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

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Geriatrics factors and SAVR

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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

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.

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

Multivariate analysis

(Cox regression model )

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Cognitive impairment

– Studies on long term cognitive decline, but not on mortality – Associated with post-operative delirium, and delirium associated with mortality

Discussion

(Maniar et al., J Thorac Cardiovasc Surg, 2016)

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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

Discussion

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Limitations

Inherent to a retrospective

analysis

Single institution
CGA results knowned by all

praticians including surgeons

Strength

Results consistent with previous studies :

One year mortality rate

(9,6%)

Cardiac predictors

associated with mortality

(Brennan et al, Circulation, 2012 Di Eusanio et al, J Thorac Cardio Surg, 2011)

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Messages

First study including all geriatrics factors
Association between cognitive impairment

and one year mortality after SAVR

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