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Is Retrograde Perfusion Safe In Elderly Patients Above 70
Hind Elhassan, Joseph Zacharias.
Blackpool Teaching Hospital, Blackpool, United Kingdom.

OBJECTIVE: In this study we aim to establish the safety of minimally invasive primary valve procedures in elderly patients with retrograde femoral arterial perfusion by examining post-operative outcomes and quality of life in elderly patients.
METHODS: This is a retrospective observational study for all patients who had minimally invasive cardiac valve surgery between 2007-2021 (n=596) and had retrograde femoral arterial perfusion. Patients who were included in the study were undergone primary valve procedure (aortic, mitral or tricuspid) regardless of the aetiology. We had compared the early, mid and long-term outcomes of patients over 70 with those under 70 years of age.RESULTS: Patients < 70 (n= 355) with mean age was 55  12 years while patients ≥ 70 (n=241) with mean age was 76.5  5 years.116 (32.6 %) patients were female in<70 group and 105 (43.5 %) in the other group. Logistic EuroScore < 70 mean of 3.8 (range 0.87-53.160) and for ≥ 70 (mean 10.07 range 1.86-67.37) (P<0.001). Mitral tricuspid procedure was performed in 177 (73.4%) in the 70 group and 291 (81.9%) in below 70. Concomitant procedures included atrial fibrillation ablation (11.2% for <70 and 23.2% in ≥70) and atrial septal defect closure (6.4 %) was only reported in <70. 61 (17.1%) aortic valve replacement were performed in <70 group and 64 (26.5%) in ≥70. In-hospital mortality was 1.7 % for <70 and 3.7% for ≥70. Sixteen patients (4.5 %) had conversion to sternotomy in the <70 and eight (3.3%) in the other group. Incidence of stroke was 0.5% in <70 and 0.8% in ≥70. CONCLUSIONS: Minimally invasive approach with retrograde femoral arterial perfusion is a safe for a spectrum of primary cardiac valve procedure in Elderly patients


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