Objective: Surgical aortic valve replacement (AVR)
remains the gold standard therapy for severe aortic
stenosis. Long-term survival data following AVR is
required. Our objective was to provide a detailed
contemporary benchmark of long-term survival
following AVR among elderly patients (≥65 years) in
the UK.
Methods: We conducted a retrospective cohort study
of 1815 adult patients undergoing surgical AVR±
coronary artery bypass graft (CABG) surgery at a single
UK centre between 1996 and 2011. Our main outcome
was patient survival, which was assessed by linkage to
census records at the Office for National Statistics.
Results: The mean age of the cohort was 75 (±5.6)
years. Patients in the AVR alone group had a slightly
higher median survival of 10.9 (95% CI 10.5 to 11.8)
years than the AVR+CABG group which had a median
survival of 9.6 (95% CI 8.7 to 10.1) years ( p=0.001 of
log-rank test (LRT) for equality of survivor functions).
The presence of chronic kidney disease, severely
impaired left ventricular function or being a current
smoker were each associated with a ≥50% increased
risk of long-term mortality. Comparison of our study
cohort patients and the reference (operation year, age
and gender matched) UK population suggested no
difference in survival probability up to 8 years
( p=0.55). However, for longer periods of follow-up, the
difference became increasingly significant ( p<0.0001).
Conclusions: Long-term survival following surgical
AVR in patients over 65 years of age is excellent and
up to 8 year