Open Heart Surgery in Octogenarians: A Review.
Until fairly recently, cardiac surgery was controversial in octogenarians. With the improvement of life quality and health services, the number of octogenarians in the population is steadily increasing. Furthermore, the improvement of surgical techniques and perioperative care permit safer cardiac surgery in this age group. Surgery is beneficial especially for patients undergoing coronary revascularization (early mortality rate, 0% to 12%) or isolated valve surgery (early mortality rate, 1.8% to 20%). Great caution should be exercised when considering candidates for combined coronary and valvular or multiple valve surgery as mortality is much higher in this group. Overall, the operative course in the very elderly is more complicated and is associated with various postoperative complications in 57% to 97% of the patients, which is reflected in longer postoperative hospitalization-an average of 10-19 days. Nevertheless, the 5-year survival in these patients is 47% to 71%. With proper selection of patients, carefully planned surgery, and meticulous postoperative care octogenarians can enjoy prolonged life expectancy and improved quality of life following open heart surgery.
Deviri
Ehud
E
Departments of Cardiothoracic Surgery, Hadassah University Hospital and Bikur Cholim Hospital, Jerusalem, Israel.
Merin
Gideon
G
Medalion
Benjamin
B
Borman
Joseph B.
JB