[Early and mid-term results after cardiac or thoracic aortic surgery in patients aged 70 years and older--survival and quality of life].
The early and mid-term survival after cardiac or thoracic aortic surgery and influence of age to the operative mortality were examined in 168 consecutive patients aged 70 years and older from August 1994 to December 1998, together with assessment of postoperative quality of life (QOL). The mean age was 74.1 +/- 3.7 years old (70 to 86 years). 80 patients had IHD, 59 had VHD, 28 had TAA. Preoperative risk score was classified in 5 groups (good, fair, poor, high, extremely high) based on Parsonnet method. Current QOL of the survivors was assessed using Asanoi method with questionnaire by a letter. There were 9 early deaths (5.4%). Following the Parsonnet model observed mortality was absolutely lower than predicted mortality. When age score was excluded in the Parsonnet model, the observed mortality became almost equal with the predicted mortality. There were 22 late deaths (6.9%/P-Y). The actuarial survival rate of age 70 to 74 group was significantly higher than the age 75 years and older group (p = 0.0021). The actuarial survival rate of TAA group was significantly lower than the VHD or IHD group (p < 0.02). Postoperative NYHA and activity score of TAA group were better than VHD or IHD group. We got satisfactory answers for operation in 95% current survivors. Patients aged 70 years and older will be undergone cardiac or thoracic aortic surgery at a reasonable risk and well satisfaction.
Komesu
I
I
Department of Cardiovascular Surgery, National Kyusyu Medical Center Hospital, Fukuoka, Japan.
Arinaga
K
K
Nakashima
A
A
Toshima
Y
Y
Oohashi
M
M
Eto
M
M
Kajihara
N
N
Ontsuka
T
T
Kimura
S
S
Kawachi
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000401:mortality* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011788:Quality of Life; D012307:Risk Factors