[Results and problems of open heart surgery in patients seventy years of age and older].
The purpose of this study was to assess the influence of aging on the surgical results. The subjects which were 70-year or older included 13 cases of acute myocardial infarction with mechanical failure (AMI), 36 of elective aortocoronary bypass (CABG) and 33 of valvular heart disease (VHD). The control group younger than 70 included 32 cases of CABG and 32 of VHD. The complication rate of hypertension or diabetes mellitus in the older group was not significantly higher than in younger group. The characteristics of the preoperative status in the older group, however, seemed to be renal and hepatic hypofunction and anemia. The amount of intraoperative bleeding in older group was larger than in younger group. The periods of ICU stay, respiratory assist and postoperative hospitalization in older group were significantly longer than in younger group. The operative mortality rate of AMI was 61.5%, of CABG 8.3% and of VHD 12.1%. The operative mortality rate of emergent or urgent operation was 47.6% and of elective one 8.2%. The 4-year survival rate of CABG was 82% and the 6-year survival rate of VHD was 85%. Sixty four survivors (95.5%) improved to I-II of NYHA classification and of only 3 survivors (4.5%) remained in NYHA III class. The operative and long term results of elective surgery in older patients were comparable to those in younger ones. Therefore aging, itself, should not be a limiting factor in 70-year or older patients with good mental activity.
Shomura
T
T
Department of Thoracic and Cardiovascular Surgery, Kobe City General Hospital, Japan.
Okada
Y
Y
Nasu
M
M
Sono
J
J
Miyamoto
S
S
Nishiuchi
S
S
Tatemichi
K
K
D000367:Age Factors; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D008297:Male