Cardiac surgery in octogenarians.
BACKGROUND
Early and late results were studied in order to improve the indications for surgery in the elderly.


METHODS
Two hundred and thirty-seven patients aged 80 years or older underwent cardiac surgery between 1987 and 2001. The mean age of patients, which included 148 men and 89 women, was 82 years. Elective operations were performed in 194 patients and urgent or emergency operations in 43. Coronary artery bypass grafting (CABG) was performed in 104 patients, valve surgery in 60, CABG plus valve in 58, and other surgery in 15. Late results were obtained in 91% of patients, and the mean follow-up period was 54 months.


RESULTS
Operative mortality was 9% in total; 7% in CABG, 5% in valve, 10% in CABG plus valve. Operative mortality was significantly higher in the urgent/emergency group than in the elective group (25% vs 6%). The actuarial survival rate for hospital survivors at 60 months after surgery was 75% and the mean survival period 76 months. There were no significant differences among operations. Preoperatively 81% of the patients had been in New York Heart Association class III or IV, and 88% of survivors were in class I or II in the late period.


CONCLUSIONS
Early and late results for elective surgery in octogenarians are satisfactory. However, for urgent or emergent cases, there is a marked increase in morbidity and mortality.
Ishikawa
Susumu
S
Department of Cardiac Surgery, Austin Hospital, University of Melbourne, Melbourne, Australia. skyishikawa@cronos.ocn.ne.jp
Buxton
Brian F
BF
Manson
Narelle
N
Hadj
Anthony
A
Seevanayagam
Siven
S
Raman
Jai S
JS
Rosalion
Alexander
A
Morishita
Yasuo
Y
D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D015996:Survival Rate; D014739:Victoria