[Cardiac surgery in the octogenarian].
Progressive ageing of the population results in an increased number of patients in their eighties referred for cardiac surgery. The combination of the effects of ageing and age-related diseases makes eighty-year-olds a group of high-risk surgical patients. Due to the increasingly limited resources of health care systems, the results of cardiac surgery in eighty-year-olds must be re-evaluated in terms of survival and postoperative quality of life. A review of the international literature concerning coronary, aortic and mitral valve surgery in eighty-year-olds suggests that the postoperative complication rate, the duration of intensive care and the early postoperative mortality are significantly higher than in younger subjects. However, the long-term survival probability is similar to that of a population of eighty-year-olds without heart disease and significantly better than after non-surgical treatment. The quality of life is usually improved by the operation as suggested by a significant reduction of the symptoms and improvement of functional capacities. The favourable long-term results of cardiac surgery in eighty-year-olds therefore compensate for the higher intraoperative risk and argue in favour of earlier intervention.
Kirsch
M
M
Hôpital Henri Mondor, Service de Chirurgie Thoracique et Cardio-vasculaire, Association Claude Bernard, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France.
Loisance
D
D
D000206:Actuarial Analysis; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over / Q000502:physiology / Q000523:psychology; D000375:Aging / Q000473:pathology / Q000502:physiology / Q000523:psychology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000523:psychology / Q000706:statistics & numerical data; D005602:France / Q000453:epidemiology; D006331:Heart Diseases / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008136:Longevity; D016017:Odds Ratio; D018579:Patient Selection; D011788:Quality of Life; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome