Leading expert in cardiac surgery, Dr. Lawrence Cohn, MD, explains that aortic valve stenosis surgery is safe and effective for patients over 80 and even into their 90s, with mortality rates under 3% in his experience. He emphasizes that the key to a successful outcome is timely intervention, advising patients to undergo surgery while their heart function is still well-compensated and their overall health is strong. Recovery for elderly patients is positive, often involving a short hospital stay followed by rehabilitation to regain strength.
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Aortic Valve Stenosis Surgery: Safe and Effective Treatment for Patients Over 80
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- Safety and Effectiveness of Heart Surgery in the Elderly
- Why Timing is Critical for Aortic Valve Surgery
- Heart Surgery Success in Patients Over 90
- The Decision-Making Process for Elderly Heart Surgery
- Recovery and Rehabilitation After Surgery
- Mitral Valve Repair in Older Patients
- The Importance of a Second Opinion
Safety and Effectiveness of Heart Surgery in the Elderly
Aortic valve stenosis surgery in elderly patients is a safe and effective procedure. Dr. Lawrence Cohn, MD, a leading cardiac surgeon, confirms that medical advancements have significantly reduced the risks associated with major heart operations for older individuals. The mortality rate for these procedures in his experience is now less than 3%. This improvement is due to refined surgical techniques, including minimally invasive aortic valve surgery and hybrid procedures.
Why Timing is Critical for Aortic Valve Surgery
The most critical factor for a successful outcome is the timing of the surgery. Dr. Lawrence Cohn, MD, strongly advises that patients should not wait for their condition to deteriorate. He recommends undergoing aortic valve replacement surgery while the patient's heart function is still reasonably well-compensated and their overall health is at its best possible state. Delaying treatment until the patient becomes very sick from advanced aortic valve stenosis dramatically increases surgical risk and reduces the potential benefits of the operation.
Heart Surgery Success in Patients Over 90
Cardiac surgery is not off the table for the oldest patients. Dr. Lawrence Cohn, MD, notes that treatment of aortic valve stenosis is possible even in patients who are 90 years old or older. He describes performing successful heart surgery on nonagenarians who were mentally sharp and had strong family support systems. These patients did exceptionally well post-operatively because the decision to proceed was made while they were still viable candidates, underscoring the principle that age alone is not a contraindication for life-saving treatment.
The Decision-Making Process for Elderly Heart Surgery
Choosing to have heart surgery is a significant decision that requires careful collaboration. Dr. Anton Titov, MD, and Dr. Lawrence Cohn, MD, highlight that patients must make this decision alongside their physicians and cardiac surgeons. The process involves a thorough evaluation of the patient's current health, heart function, and personal support network. The consensus from Dr. Cohn is clear: an early decision to proceed with surgery while the heart is still functioning well is the key to success.
Recovery and Rehabilitation After Surgery
Recovery for elderly patients after heart surgery is positive and manageable. Dr. Lawrence Cohn, MD, states that the hospital stay for an older patient is "not too bad." It is common for elderly patients to transfer to a rehabilitation center or nursing home after discharge to regain strength in their arms and legs. This period of focused recovery helps them return to their normal activities, and they often recover in a similar fashion to younger patients following the same procedures.
Mitral Valve Repair in Older Patients
The principles of safe and effective heart surgery also apply to other valve procedures. Mitral valve surgery, particularly mitral valve repair, is also a safe and effective option for elderly patients over 80. Dr. Cohn confirms that recovery after mitral valve repair in older patients is good and carries many benefits. As with aortic valve surgery, the same rule applies: patients should not delay mitral valve repair for too long to ensure the best possible outcome.
The Importance of a Second Opinion
For a condition as serious as aortic valve stenosis, seeking a second opinion is a prudent step. A second opinion confirms that the diagnosis of aortic valve stenosis is correct and complete. It also helps patients and their families choose the best treatment option, providing confidence that the selected course of action—whether it be surgical or alternative—is the most appropriate for their specific situation. Dr. Anton Titov, MD, discusses this as a way to ensure all avenues are explored before making a final decision.
Full Transcript
Dr. Lawrence Cohn, MD: Aortic valve stenosis surgery in elderly patients after 80 is safe and effective. Mitral valve surgery is also safe and effective for elderly patients. But older patients should not delay heart surgery for too long.
Dr. Anton Titov, MD: Heart valve surgery in elderly patients over 80 is safe and effective. Open heart surgery in older patients includes coronary artery bypass surgery in the 80 plus age range. Recovery of elderly patients after mitral valve repair is good. Mitral valve repair in older patients has many benefits.
Dr. Lawrence Cohn, MD: Treatment of aortic valve stenosis is possible even in patients who are 90 years old. Aortic valve stenosis surgery in the elderly is safe and effective. But patients should not wait for deterioration in their condition. Heart surgery in the elderly has to be timely.
Dr. Anton Titov, MD: Video interview with leading expert in cardiac surgery. Second opinion confirms that aortic valve stenosis in elderly diagnosis is correct and complete. Second opinion helps to choose the best treatment for aortic valve stenosis in elderly patients. Get second opinion on aortic valve stenosis and be confident that your treatment is the best.
Mitral valve repair in older patients after 80. More patients need heart operations when they are older. Need for major surgery affects quality of life of patients. Patients and their families have to make serious decisions.
Dr. Lawrence Cohn, MD: Medical care gets better. More and more patients are living into the eighties and even nineties around the world. A lot of elderly patients develop aortic stenosis because aortic stenosis is a degenerative disease.
There are several points about that. First, the risk of heart operation for elderly patients has come down. Particularly the risk of minimal invasive aortic valve surgery has decreased. Risks of hybrid heart surgery and endovascular procedures have come down. Mortality in our experience is less than 3%.
But the patient should not wait too long. Because sometimes the elderly patient has aortic stenosis. When this patient is in good health, the patient should not wait too long to have heart surgery to treat aortic stenosis.
Do surgery to replace heart valve when your heart function is reasonably well compensated. Elderly patients should have heart surgery when they are in the best possible shape. This means their risk of surgery is as low as it can be.
Sometimes elderly patients wait too long. They become very sick from their heart valve problem. Then the risk of operation becomes very high. Then benefits of heart valve surgery are reduced.
So patients should think about having heart surgery earlier. Do not have heart valve replacement or repair surgery too late. We did heart surgery to treat aortic valve stenosis in patients who are 90 years old. Some patients were more than 90 years old.
Because patients were very viable. Their mind was in excellent shape. Patients had support of the family and friends. These patients did great after surgery because everyone wanted them to get better.
But you cannot wait too long to decide whether to have heart surgery. That is the key to success of operation. Correct timing to have heart surgery is most important.
Patients have to make a decision about heart surgery with their physicians and surgeons.
Dr. Anton Titov, MD: Patients must decide on surgery while their heart still functions well.
Dr. Lawrence Cohn, MD: Exactly, that is correct. Early decision is the key to success of heart surgery. Surgery can be done safely in very elderly patients. But heart surgery in elderly patients has to be done earlier rather than later.
Is hospital stay of elderly patients after heart surgery longer or not?
No, elderly patient's length of time spent in the hospital is not too bad. A lot of elderly patients go after heart surgery to rehabilitation centers and nursing homes. They need just to recover and to regain their strength in arms and legs. But elderly patients recover in a similar fashion as other patients after heart surgery.
Dr. Anton Titov, MD: Aortic valve stenosis surgery in elderly after 80. Mitral valve repair in patients over 80 is also safe and effective. But patients must not wait too long.