Age and Survival After Surgical Aortic Valve Replacement in Patients with Severe Aortic Stenosis: CURRENT AS Registry

Abstract BACKGROUND There is a paucity of data regarding loss in life expectancy after aortic valve replacement (AVR) in patients with severe aortic stenosis (AS).OBJECTIVES The purpose of this study was to assess the postoperative survival stratified by age and surgical risk, with reference to the life expectancy in the general population.METHODS Among 3815 patients with severe AS enrolled in the CURRENT AS registry, the present study population consisted of 1163 patients who actually underwent surgical AVR as the initial strategy. Patients were divided into 4 groups according to age (<65: N=185, 65-74: N=394, 75-80: N=345, and >80: N=239). The expected survival of the general Japanese population was obtained from the Statistics Bureau of Japan. The surgical risk was estimated using the Society of Thoracic Surgery (STS) score.RESULTS The mean follow-up was 3.9 years. The observed mortality after surgical AVR in patients ≤80 years of age was apparently higher than the expected mortality in the general population, while the mortality in patients >80 years of age was comparable to the expected mortality. The observed mortality in low-risk patients was comparable to the expected mortality across all the age groups, while intermediate-risk patients <75 years of age, and high-risk patients across all age groups had higher mortality compared with the expected mortality. CONCLUSIONS The risk stratification according to age and STS score might be useful to estimate loss in life expectancy after AVR, and these findings have implications for decision making in the choice of surgical or transcatheter AVR.URL: www.umin.ac.jp/ctr/index.htm. Unique identifier: UMIN000012140.