title: Cardiac surgery in octogenarians--a better prognosis in coronary artery disease.
abstract: BACKGROUND
  Cardiac surgery is being performed with increasing frequency in patients aged 80 years and older.
  
  
  OBJECTIVE
  To examine the long and short-term results of surgery in this age group.
  
  
  METHODS
  We retrospectively investigated 202 consecutive patients aged 80 years or older who underwent cardiac surgery between 1991 and 1999, Ninety-six operations (48%) were urgent.
  
  
  RESULTS
  The study group comprised 140 men (69%) and 62 women (31%) with a mean age of 82.1 years (range 80-89). Preoperatively, 120 patients (59%) had unstable angina, 37 (18%) had left main coronary artery disease, 22 (11%) had renal failure, 17 (8.5%) had a history of stroke and 13 (6.5%) had previous cardiac surgery. Hospital mortality for the whole group was 7.4%. Postoperative complications included: re-exploration for bleeding in 15 (7.4%), stroke in 8 (4%), sternal wound infection in 3 (1.5%), low cardiac output in 17 (8.4%), new Q wave myocardial infarction in 5 (2.5%), renal failure in 17 (8.5%), and atrial fibrillation in 71 (35%). The actuarial survival for patients discharged from the hospital was 66% at 5 years and 46% at 8 years. The type of surgical procedure was significantly associated with increased early mortality (coronary artery bypass grafting only in 2.9%, CABG + valve in 16.1%, valve only in 16.7%; P = 0.01). Significant predictors (P < 0.05) for late mortality included type of surgical procedure, congestive heart failure, and postoperative low cardiac output.
  
  
  CONCLUSIONS
  When appropriately applied in selected octogenarians, cardiac surgery can be performed with acceptable mortality and good long-term results.
authors.affiliation: Department of Cardiothoracic Surgery, Hadassah University Hospital, Hebrew University-Hadassah Medical School, Jerusalem, Israel. rgerrah@yahoo.com
authors.forename: Rabin
authors.initials: R
authors.lastname: Gerrah
authors.forename: Uzi
authors.initials: U
authors.lastname: Izhar
authors.forename: Amir
authors.initials: A
authors.lastname: Elami
authors.forename: Eli
authors.initials: E
authors.lastname: Milgalter
authors.forename: Ehud
authors.initials: E
authors.lastname: Rudis
authors.forename: Gideon
authors.initials: G
authors.lastname: Merin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005853:Geriatrics; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate