Cardiac surgery in patients aged 80 years and older.
OBJECTIVE
We studied disease and surgical outcomes in an 80-plus age group to determine the feasibility of cardiac surgery at this age.


METHODS
Between January 1991 and August 2000, we statistically analyzed 19 variables in 62 consecutive cases of cardiac surgery in the 80-plus age group to predict in-hospital and long-term mortality. Cases were classified by disease type (ischemic heart disease (IHD), n = 39; valvular heart disease (VHD) n = 19; and mechanical complications associated with acute myocardial infarction, n = 4; and by surgical status (emergency, n = 6; urgent, n = 10; and elective, n = 46). We compared these with 370 patients 70 to 79 years undergoing similar procedures during the same interval.


RESULTS
No significant difference was seen between groups in total in-hospital mortality--9.7% vs. 3.8%--or in-hospital mortality for IHD--2.6% vs. 4.2%--or VHD--10.5% vs. 2.8%. We found cardiopulmonary bypass time > 150 min. and dialysis to be independent risk factors for hospital death. Actuarial survival at 7.5 years overall was 39% in the 80-plus age group vs. 53% in the 70-79 age group for VHD and 38% in the 80-plus age group vs. 62% in the 70-79 age group. No significant difference was seen in survival between groups for IHD. Stroke proved to be an independent prognostic factor.


CONCLUSIONS
Cardiac surgery is conducted feasibly in selected octogenarians, providing acceptable mortality and results similar to those achieved in those 70 to 79 years old.
Tanaka
Masashi
M
Department of Cardiovascular Surgery, Omiya Medical Center, Jichi Medical School, 1-847 Amanuma, Saitama 330-0834, Japan.
Kawahito
Koji
K
Adachi
Hideo
H
Yamaguchi
Atsushi
A
Ino
Takashi
T
D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D004630:Emergencies; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome