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Valvular Heart Disease in the Elderly

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Cardiovascular Disease in the Elderly

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 76))

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Abstract

Valvular heart disease in the elderly has commanded increasing attention in the past decade [1–5]. A prime reason has been the steady lowering of operative risk from open heart surgery [6–10]. Noninvasive diagnostic procedures such as echocardiography, radionuclide ventriculography, and more recently Doppler. echocardiography allow accurate confirmation of clinical diagnoses in most cases [11–17]. With regard to therapy, criteria based on noninvasive studies have been proposed for use in clinical decision making in selected disease states.

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References

  1. Wenger NK. Selected cardiac problems in the elderly patient. J Med Ass Ga 68:1033–1041, 1979.

    CAS  Google Scholar 

  2. Burch GE. Interesting aspects of geriatric cardiology. Am Heart J 89:99–114, 1975.

    Article  PubMed  CAS  Google Scholar 

  3. Kotler MN, Mintz GS, Parry WR, and Segal B. Bedside diagnosis of organic murmurs in the elderly. Geriatrics 36:107–125, 1981.

    PubMed  CAS  Google Scholar 

  4. Sugiura M, Ohkawa S, Hiraoka K, et al. A clinicopathologic study on valvular heart diseases in 1,000 consecutive autopsy of the aged. Jpn Heart J 22:1–13, 1981.

    Article  PubMed  CAS  Google Scholar 

  5. Collins P, Cotton RE, and Duff RS. Symptomatic mitral myxomatous transformation in the elderly. Thorax 31:765–770, 1976.

    Article  PubMed  CAS  Google Scholar 

  6. Jamieson WRE, Dooner J, Munro AI, et al. Cardiac valve replacement in the elderly: A review of 320 consecutive cases. Circulation 64:11–177–11–183, 1981.

    Google Scholar 

  7. Murphy ES, Lawson RM, Starr A, and Rahimtoola SH. Severe aortic stenosis in patients 60 years of age or older: Left ventricular function and 10-year survival after valve replacement. Circulation 64:11–184–11–191, 1981.

    Google Scholar 

  8. Copeland JG, Griepp RB, Stinson EB, and Shumway NE. Isolated aortic valve replacement in patients older than 65 years. JAMA 237:1578–1581, 1977.

    Article  PubMed  CAS  Google Scholar 

  9. Hochberg MS, Morrow AG, Michaelis LL, et al. Aortic valve replacement in the elderly. Encouraging postoperative clinical and hemodynamic results. Arch Surg 112:1475–1480, 1977.

    Article  PubMed  CAS  Google Scholar 

  10. Quinlan R, Cohn LH, and Collins JJ. Determinants of survival following cardiac operations in elderly patients. Chest 68:498–500, 1975.

    Article  PubMed  CAS  Google Scholar 

  11. Feigenbaum H. The value of echocardiography in older patients. Geriatrics 30(1):106–111, 1975.

    PubMed  CAS  Google Scholar 

  12. Tam PH. Mitral and aortic valvular disease in the elderly. NY State J Med 79:378–381, 1979.

    CAS  Google Scholar 

  13. Flohr KH, Weir EK, and Chesler E. Diagnosis of aortic stenosis in older age groups using external carotid pulse recording and phonocardiography. Br Heart J 45:577–582, 1981.

    Article  PubMed  CAS  Google Scholar 

  14. Higgins CB, Reinke RT, Gosink BB, and Leopold GR. The significance of mitral valve prolapse in middle-aged and elderly men. Am Heart J 91:292–296, 1976.

    Article  PubMed  CAS  Google Scholar 

  15. Schwartz A, Vignola PA, Walker HJ, et al. Echocardiographic estimation of aortic-valve gradient in aortic stenosis. Ann Int Med 89:329–335, 1978.

    Article  PubMed  CAS  Google Scholar 

  16. Borer JS, Bacharach SL, Green MV, et al. Exercise-induced left ventricular dysfunction in symptomatic and asymptomatic patients with aortic regurgitation: Assessment with radionuclide cineangiography. Am J Cardiol 42:351–357, 1978.

    Article  PubMed  CAS  Google Scholar 

  17. Port S, Cobb FR, Coleman RE, and Jones RH. Effect of age on the response of the left ventricular ejection fraction to exercise. N Engl J Med 303:1133–1137, 1980.

    Article  PubMed  CAS  Google Scholar 

  18. Burch GE. Geriatric cardiology. Am Heart J 78:700–708, 1969.

    Article  PubMed  CAS  Google Scholar 

  19. Edwards JE. Calcific aortic stenosis: Pathologic features. Mayo Clin Proc 36:444–451, 1961.

    CAS  Google Scholar 

  20. Roberts WC. The congenitally bicuspid aortic valve: A study of 85 autopsy cases. Am J Cardiol 26:72–83, 1970.

    Article  PubMed  CAS  Google Scholar 

  21. Pomerance A. Pathogenesis of aortic stenosis and its relationship to age. Br Heart J 34:569–574, 1972.

    Article  PubMed  CAS  Google Scholar 

  22. Rotman M, Morris JJ, Behar VS, et al. Aortic valvular disease: Comparison of types and their medical and surgical management. Am J Med 51:241–257, 1971.

    Article  PubMed  CAS  Google Scholar 

  23. Urrichio JF, Sinha KP, Bentivoglio L, and Goldberg H. A study of combined mitral and aortic stenosis. Ann Int Med 51:668–678, 1959.

    Article  Google Scholar 

  24. Vollebergh FEMB and Becker AE. Minor variations of cusp size in tricuspid aortic valves. Possible link with isolated aortic stenosis. Br Heart J 30:1006–1011, 1977.

    Article  Google Scholar 

  25. Rapaport E. Natural history of aortic and mitral valve disease. Am J Cardiol 35:221–227, 1975.

    Article  PubMed  CAS  Google Scholar 

  26. Spodick DH, Sugiura T, Doi Y, et al. Rate of rise of the carotid pulse. An investigation of observer error in a common clinical measurement. Am J Cardiol 49:159–162, 1982,

    Article  Google Scholar 

  27. DeMaria AN, Bommer W, Joye J, et al. Value and limitations of cross-sectional echocardiography of the aortic valve in the diagnosis and quantification of valvular aortic stenosis. Circulation 62:304–312, 1980.

    Article  PubMed  CAS  Google Scholar 

  28. Williams DE, Sahn DJ, and Friedman WF. Cross-sectional echocardiographic localization of sites of left ventricular outflow tract obsrruction. Am J Cardiol 37:250–255, 1976.

    Article  PubMed  CAS  Google Scholar 

  29. Smith, MD, Dawson PL, Elion JL, et al. Correlation of continuous wave Doppler velocities with cardiac catheterization gradients: An experimental model of aortic stenosis. J Am Coll Cardiol 6:1306–1314, 1985.

    Article  PubMed  CAS  Google Scholar 

  30. Hatle A, Angelsen BA, and Transdal A. Noninvasive assessment of aortic stenosis by Doppler ultrasound. Br Heart J 43:284–292, 1980.

    Article  PubMed  CAS  Google Scholar 

  31. Stamm RB and Martin RP. Quantification of pressure gradients across stenotic valves by Doppler ultrasound. J Am Coll Cardiol 2:707–718, 1983.

    Article  PubMed  CAS  Google Scholar 

  32. Zaghbi WA, Farmer KL, Soto JG, et al. Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography. Circulation 73:452–459, 1986.

    Article  Google Scholar 

  33. Ohlsson J and Wranne B. Noninvasive assessment of valve area in patients with aortic stenosis. J Am Coll Cardiol 7:501–508, 1986.

    Article  PubMed  CAS  Google Scholar 

  34. Otto CM, Pearlman AS, Comess KA, et al. Determination of the stenotic aortic valve area in adults using Doppler echocardiography. J Am Coll Cardiol 7:509–517, 1986.

    Article  PubMed  CAS  Google Scholar 

  35. Miller WE, Richards KL, Miller JF, and Crawford MH. Aortic valve area and mean pressure gradient by combined imaging and Doppler echo. Circulation 72:(abstract):III-144, 1985.

    Google Scholar 

  36. St. John Sutton MG, St. John Sutton M, Oldershaw P, et al. Valve replacement without preoperative cardiac catheterization. N Engl J Med 305:1233–1238, 1981.

    Article  PubMed  CAS  Google Scholar 

  37. Brandenburg RO. No more routine catheterization for valvular heart disease? N Engl J Med 305:1277–1278, 1981.

    Article  PubMed  CAS  Google Scholar 

  38. Bonchek LI. Current status of cardiac valve replacement: Selection of a prosthesis and indications for operation. Am Heart J 101:96–106, 1981.

    Article  PubMed  CAS  Google Scholar 

  39. Ferrans VJ, Boyce SW, Bilhngham ME, et al. Calcific deposits in porcine bioprostheses: Structure and pathogenesis. Am J Cardiol 46:721–734, 1980.

    Article  PubMed  CAS  Google Scholar 

  40. Cohn LH, Mudge GH, Pratter F, and Collins JJ. Five- to eight-year follow-up of patients undergoing porcine heart-valve replacement. N Engl J Med 304:258–262, 1981.

    Article  PubMed  CAS  Google Scholar 

  41. Kirklin JW. The replacement of cardiac valves. N Engl J Med 304:291–292, 1981.

    Article  PubMed  CAS  Google Scholar 

  42. Bonow RO, Kent KM, Rosing DR, et al. Aortic valve replacement without myocardial revascularization in patients with combined aortic valvular and coronary artery disease. Circulation 63:243–251, 1981.

    Article  PubMed  CAS  Google Scholar 

  43. Richardson JV, Kouchoukos NT, Wright JO III, and Karp RB. Combined aortic valve replacement and myocardial revascularization: Results in 220 patients. Circulation 59:75–81, 1979.

    Article  PubMed  CAS  Google Scholar 

  44. Kirklin JW and Kouchoukos NT. Aortic valve replacement without myocardial revascularization. Circulation 63:252–253, 1981.

    Article  PubMed  CAS  Google Scholar 

  45. Enghoff E. Aortic incompetence: Clinical hemodynamic and angiographic evaluation. Acta Med Scand, Suppl 538:3–17, 1972.

    CAS  Google Scholar 

  46. Stapleton JR and Harvey WP. Clinical analysis of aortic incompetence. Postgrad Med 46:156–165, 1969.

    PubMed  CAS  Google Scholar 

  47. Roberts WC, Dangel JC, and Bulkley BH. Nonrheumatic valvular heart disease: A clinicopathologic survey of 27 different conditions causing valvular dysfunction. In W Likoff (ed), Valvular Heart Disease. Cardiovasc Clin 5:333, 1973.

    Google Scholar 

  48. Roberts WC. Anatomically isolated valvular disease: The case against its being of rheumatic etiology. Am J Med 49:151–159, 1970.

    Article  PubMed  CAS  Google Scholar 

  49. Waller BF, Zoltick JM, Rosen JH, et al. Severe aortic regurgitation from systemic hypertension (without aortic dissection) requiring aortic valve replacement. Am J Cardiol 49:473–477, 1982.

    Article  PubMed  CAS  Google Scholar 

  50. Prewitt TA. Syphilitic aortic insufficiency. Its increased incidence in the elderly. JAMA 211:637–639, 1970.

    Article  PubMed  CAS  Google Scholar 

  51. Fortuin NJ and Craige E. On the mechanism of the Austin Flint murmur. Circulation 45:558–570, 1972.

    Article  PubMed  CAS  Google Scholar 

  52. Morganroth J, PerloffJK, Zeldis SM, and Dunkman WB. Acute severe aortic regurgitation. Ann Int Med 87:223–232, 1977.

    Article  PubMed  CAS  Google Scholar 

  53. Ciobanu M, Abbasi AS, Allen M, et al. Pulsed Doppler echocardiography in the diagnosis and estimation of severity of aortic insufficiency. Am J Cardiol 49:339–343, 1982.

    Article  PubMed  CAS  Google Scholar 

  54. Handshoe R, Handshoe S, Kwan OL, et al. Value and limitations of Dopler measurements in the estimation of left ventricular end diastolic pressure in patients with aortic regurgitation. Circulation 70 (Abstract):II-117, 1984.

    Google Scholar 

  55. Grayburn PA, Nissen SE, Elion JL, et al. Quantitation of aortic regurgitation by computer analysis of digital subtraction angiography. J Am Coll Cardiol 7(Abstract):154A, 1986.

    Google Scholar 

  56. Henry WL, Bonow RO, Borer JS, et al. Observations on the optimum time for operative intervention for aortic regurgitation. I. Evaluation of the results of aortic valve replacement in symptomatic patients. Circulation 61:471–483, 1980.

    Article  PubMed  CAS  Google Scholar 

  57. Henry WL, Bonow RO, Rosing DR, and Epstein SE. Observations on the optimum time for operative intervention for aortic regurgitation. I. Serial echocardiographic evaluation of asymptomatic patients. Circulation 61:484–492, 1980.

    Article  PubMed  CAS  Google Scholar 

  58. Bonow RO, Picone AL, McIntosh CL, et al. Survival and functional results after aortic valve replacement for aortic regurgitation from 1976 to 1983: Impact of preoperative left ventricular function. Circulation 72:1244–1256, 1985.

    Article  PubMed  CAS  Google Scholar 

  59. Roberts WC and Perloff JF. Mitral valvular disease. A clinicopathologic survey of the conditions causing the mitral valve to function abnormally. Ann Int Med 77:939–975, 1972.

    Article  PubMed  CAS  Google Scholar 

  60. Collins P, Cotton RE, and Duff RS. Symptomatic mitral myxomatous transformation in the elderly. Thorax 31:765–770, 1976.

    Article  PubMed  CAS  Google Scholar 

  61. Fulkerson PK, Beaver BM, Auseon JC, and Graber HL. Calcification of the mitral anulus. Etiology, clinical associations, complications and therapy. Am J Med 66:967–977, 1979.

    Article  PubMed  CAS  Google Scholar 

  62. D’Cruz I, Panetta F, Cohen H, and Glick G. Submitral calcification or sclerosis in elderly patients: M-mode and two-dimensional echocardiograhy in “mitral anulus calcification.” Am J Cardiol 44:31–38, 1979.

    Article  PubMed  Google Scholar 

  63. Hammer WJ, Roberts WC, and de Leon AC. “Mitral stenosis” secondary to combined “massive” mitral anular calcific deposits and small, hypertrophied left ventricles. Hemodynamic documentation in four patients. Am J Med 64:371–376, 1978.

    Article  PubMed  CAS  Google Scholar 

  64. Jeresaty RM. Mitral Valve Prolapse. New York: Raven Press, 1979.

    Google Scholar 

  65. Barnett HJM, Boughner DR, Taylor DW, et al. Further evidence relating mitral valve prolapse to cerebral ischemic events. N Engl J Med 302:139–144, 1980.

    Article  PubMed  CAS  Google Scholar 

  66. Knopman D, Anderson DC, Greenland P, et al. Mitral valve prolapse and cerebral ischemic events in the elderly. N Engl J Med 303:641 (letter), 1980.

    Google Scholar 

  67. Mills P, Rose R, Hollingsworth J, et al. Long-term prognosis of mitral valve prolapse. N Engl J Med 297:13–18, 1977.

    Article  PubMed  CAS  Google Scholar 

  68. Zile MR, Gaasch WH, and Levine HJ. Left ventricular stress-dimension-shortening relations before and after correction of chronic aortic and mitral regurgitation. Am J Cardiol 56:99–105, 1985.

    Article  PubMed  CAS  Google Scholar 

  69. Schuler G, Peterson KL, Johnson A, et al. Temporal response of left ventricular performance to mitral valve surgery. Circulation 59:1218–1231, 1979.

    Article  PubMed  CAS  Google Scholar 

  70. Ross J. Left ventricular function and timing of surgical treatment in valvular heart disease. Ann Intern Med 94:498–504, 1981.

    Article  PubMed  Google Scholar 

  71. Hochberg MS, Derkae WM, Conkle DM, et al. Mitral valve replacement in elderly patients. Encouraging postoperative results. J Thorac Cardivasc Surg 77:422–426, 1979.

    CAS  Google Scholar 

  72. Carpentier A, Chauvaud S, and Fabiani JN. Reconstructive surgery of mitral valve incompetence. Ten-year appraisal. J Thorac Cardiovasc Surg 79:338–348, 1980.

    PubMed  CAS  Google Scholar 

  73. Cosgrove DM, Chavez A, Lytle BW, et al. Results of mitral valve reconstruction. Circulation 72(Abstract):III-210, 1985.

    Google Scholar 

  74. Limas CJ. Mitral stenosis in the elderly. Geriatrics 26 (part 2): 75–79, 1971.

    PubMed  CAS  Google Scholar 

  75. Smith MD, Handshoe R, Handshoe S, et al. Comparative accüracy of two-dimensional echocardiography and Doppler pressure half-time methods in assessing severity of mitral stenosis in patients with and without prior commissurotomy. Circulation 73:100–107, 1986.

    Article  PubMed  CAS  Google Scholar 

  76. Lang R, Klein HO, Guerrero J, et al. Verapamil improves maximal exercise capacity in digitalized patients with chronic atrial fibrillation: A double-blind crossover study. Circulation 64(Abstract):IV-296, 1981.

    Google Scholar 

  77. Lock JE, Khalilullah M, Shrivastava S, et al. Percutaneous catheter commissurotomy in rheumatic mitral stenosis. N Engl J Med 313:1515–1518, 1985.

    Article  PubMed  CAS  Google Scholar 

  78. Hendel N, Leckie B, and Richards J. Carcinoid heart disease: Eight-year survival following tricuspid replacement and pulmonary valvotomy. Ann Thor Sur 30:391–395, 1980.

    Article  CAS  Google Scholar 

  79. Johnson LW, Grossman W, Dalen JE, and Dexter L. Pulmonic stenosis in the adult: Long-term follow-up results. N Engl J Med 287:1159–1163, 1972.

    Article  PubMed  CAS  Google Scholar 

  80. Chino F, Kodama A, Otake M, and Dock DS. Nonbacterial thrombotic endocarditis in a Japanese autopsy sample. A review of eighty cases. Am Heart J 90:190–198, 1975.

    Article  PubMed  CAS  Google Scholar 

  81. Klein RS, Rocco RA, Catalano MT, et al. Association of Streptococcus bovis with carcinoma of the colon. N Engl J Med 297:800–802, 1977.

    Article  PubMed  CAS  Google Scholar 

  82. McAllister HA. Primary tumors and cysts of the heart and pericardium. Curr Probl Cardiol 4:1–51, 1979.

    Article  PubMed  Google Scholar 

  83. Bashery RI and Nochumson S. Cardiac myxoma. Biochemical analyses and evidence for its neoplastic nature. NY State J Med 79:29–32, 1979.

    Google Scholar 

  84. Sayler WR, Page DL, and Hutchins GM. The development of cardiac myxomas and papillary endocardial lesions from mural thrombus. Am Heart J 89:4–17, 1975.

    Article  Google Scholar 

  85. Lappe DL, Bulkley GH, and Weiss JL. Two-dimensional echocardiography diagnosis of the left atrial myxoma. Chest 74:55–58, 1978.

    Article  PubMed  CAS  Google Scholar 

  86. Donahoo JS, Weiss JL, Gardner TJ, et al. Current management of atrial myxoma with emphasis on a new diagnostic technique. Ann Surg 189:763–768, 1979.

    Article  PubMed  CAS  Google Scholar 

  87. Walton JA, Kahn DR, and Willis PW. Recurrence of a left atrial myxoma. Am J Cardiol 29:872–876, 1972.

    Article  PubMed  Google Scholar 

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Authors
  1. David C. Booth
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  2. Anthony N. Demaria
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Editors and Affiliations

  1. Alton Ochsner Medical Foundation, New Orleans, Louisiana, USA

    Franz H. Messerli

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© 1987 Springer Science+Business Media Dordrecht

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Booth, D.C., Demaria, A.N. (1987). Valvular Heart Disease in the Elderly. In: Messerli, F.H. (eds) Cardiovascular Disease in the Elderly. Developments in Cardiovascular Medicine, vol 76. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-9925-4_9

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  • DOI: https://doi.org/10.1007/978-1-4684-9925-4_9

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4684-9927-8

  • Online ISBN: 978-1-4684-9925-4

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