title: [Cardiac Surgery in very high-risk patients].
abstract: OBJECTIVE
  To assess the results obtained in very high-risk patients, which are those patients with an EUROSCORE greater than 13 points.
  
  
  METHODS
  From September 2001 to September 2003, thirty-three very high-risk patients were operated on in our department, which represents 1.6% of all the surgical activity during that period of time, being 17 male and 16 female, with an average of 69 years old (maximum 86 and minimum 32). Diagnosis includes: post infarction CIV 5, coronary insufficiency 11, aortic dissection 3, mitral prosthesis 3, valvular disease 9, aortic prosthesis disfunction 2. Fifteen patients underwent an emergency procedure, 12 were urgent and the remaining 6 were electively operated on.
  
  
  RESULTS
  Overall post-operative mortality was 12 patients (36%), being 6 emergent, 5 urgent and 1 elective patient. Patients who survived the operation had longer intensive care and hospital admission periods, which will be analyzed in detail.
  
  
  CONCLUSIONS
  Surgery can be justified in very high risk patients. Despite the high perioperative mortality and longer periods of hospital stay, they will be otherwise condamned to death, if surgery would not be performed.
authors.affiliation: Serviço de Cirurgia Cardio-Torácica do Hospital de Santa Marta, Lisboa.
authors.forename: Pedro
authors.initials: P
authors.lastname: Coelho
authors.forename: Nelson
authors.initials: N
authors.lastname: Castelão
authors.forename: José
authors.initials: J
authors.lastname: Roquette
mesh_terms: D006348:Cardiac Surgical Procedures; D006801:Humans; D007902:Length of Stay; D011475:Prosthesis Failure; D018570:Risk Assessment; D012307:Risk Factors