Cardiac surgery in the elderly from the point of cardiologist. Evaluation of risk and outcome.
Prolongation of life expectancy, increasing incidence of coronary artery disease, advances in surgical techniques and in care of elderly patients are reasons of elevating the number of prospective candidates in this age group for cardiac surgery. Although advanced age is considered as a risk factor for any form of surgical treatment and is usually associated with higher postoperative morbidity and mortality rates. The paper submitted clarifies numerous problem areas concerning this topic in the group of patients over 65 years. The factors affecting decision-making for surgical treatment are analyzed. The specific problems concerning this age group: significant disease severity, more comorbid illnesses are discussed. Some specifics of cardiac surgery (coronary artery bypass grafting and/or valve surgery) are dealt with. An increased attention should be devoted to mental and metabolic state and general physical condition (level of fitness and activity). High level of activity and intellectual functions, re-socialization efforts following surgery and adequate social background of the patient also play an important role. According to these facts individualized approach in indication for surgery is emphasized. (Ref. 45.)
Kanalikova
K
K
Department of Cardiosurgery, Slovak Cardiovascular Institute, Pod Krasnou horkou 1, SK-833 48 Bratislava, Slovakia. kanalikova@susch.sk
D000367:Age Factors; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D018579:Patient Selection; D011183:Postoperative Complications; D012307:Risk Factors