Percutaneous XXXX in octogenarians: morbidity and mortality.

@entity1 @entity712 @entity2333 @entity472 @entity1455
STUDY OBJECTIVE: To examine the morbidity, mortality, and hospital course of an elderly @entity1 sample (mean age, 86 years; 95% CI, 84 to 87) having percutaneous @entity2333 . DESIGN: Retrospective consecutive case series before and after balloon valvuloplasty. SETTING: Tertiary care referral hospital. @entity1 : Consecutive sample of 26 @entity1 aged 80 years or older with symptomatic @entity472 referred for balloon valvuloplasty from July 1987 to July 1988. MEASUREMENTS AND MAIN RESULTS: Percutaneous @entity2333 reduced the transvalvular gradient from 59 (95% CI, 51 to 67) to 31 mm Hg (95% CI, 26 to 35; P less than 0.0001) and increased aortic valve area from 0.45 (95% CI, 0.38 to 0.51) to 0.67 cm2 (95% CI, 0.58 to 0.76; P less than 0.0001). The mean length of hospital stay for the entire study population was 11.2 days (95% CI, 7.3 to 15.2) at a total hospital charge per @entity1 of  29,600 (95% CI, 21,050 to 38,150). For @entity1 having procedural complications (11 complications in 8 @entity1 ), surgical procedures, or @entity1455 , the mean hospital stay increased to 16.2 days (95% CI, 6.2 to 26.2; P less than 0.05) and the hospital charge increased to  44,400 (95% CI, 24,280 to 64,520; P less than 0.01). Two @entity1 who presented with @entity1455 died, and 1 @entity1 had an aortic valve replacement before discharge. Four @entity1 were recently discharged (less than 1 month) and follow-up was obtained in the remaining 19 @entity1 at 6.1 months (95% CI, 4.1 to 8.1). Five more @entity1 , including the remaining @entity1 who presented with @entity1455 , died after discharge for an overall mortality of 32%. Twelve of the remaining fourteen @entity1 had fewer symptoms and improved an average of 1.1 New York Heart Association classes (95% CI, 0.7 to 1.4; P less than 0.0001). CONCLUSIONS: Percutaneous @entity2333 in @entity1 80 years and older improves hemodynamics and symptoms of @entity712 during short-term follow-up in most @entity1 , but overall mortality is high in this elderly @entity1 population. Hospital charges and length of stay were much higher in @entity1 with complications or coexisting medical illnesses. Valvuloplasty is a reasonable alternative treatment for @entity1 with @entity472 who require palliative treatment of symptoms and have high surgical risk.
